Funeral collection pack request - Great North Air Ambulance Service

Name*

Title First Last

Email*

Phone*

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This is my

Home postcode*

ZIP / Postal Code

Address*

Street Address Address Line 2 City Country

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Or, enter address manually

Are you a former patient of the charity or know someone who is?*

Yes
No

Please tell us more about your connection to GNAAS

Who are you collecting money in memory of?*

First Last

What is their relationship to you?*

Date of funeral service*

If the funeral date is within the next two working days, please contact our head office on 01325 487263 to check if we can send your pack to you in time

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Would you like any gift aid envelopes?*

Gift Aid envelopes enable us to claim Gift Aid on individual donations from UK Tax Payers, this means we can receive an extra 25p for every £1 donated.

Yes
No

How many would you like?

We send a maximum of 30 envelopes as standard, if you require any more please state in the Other Information box below

If you have any other information which may be useful please provide it below.

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Is admin user

Yes

Staff Marketing Consent Script
We'd love to keep you up-to-date with our life-saving missions and how you can help us rescue more people through fundraising, events and volunteering. Would you prefer this by email, SMS or both?

We may also occasionally contact you by post or phone. You can tell me now or at any point in the future if you’d prefer us not to do this. [For background – it is unlikely that we would contact them more than four times a year by phone/post]

How would you like to hear from us?

We'd love to keep you up-to-date with our lifesaving missions and how you can help us rescue more people through fundraising, events and volunteering. Please let us know how you'd like to hear from us.

Email
SMS

We also communicate with supporters by post or telephone to tell you more about our critical care service and the exciting ways you can support us. You can read more about this in our Privacy Policy or you can click here to not receive communications this way.

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