Personal details

Donation by Direct Debit


Did you receive a mailing in the post? If yes, please add your unique reference number here:

Details
*Title
*First name
*Surname
*Telephone
Mobile no
Date of birth
*Email address
Address
Enter postcode (and optionally house number in Address line 1) then click 'Find address'
*Postcode
*Address line 1
*Town
County
*How did you hear about Friends of LOROS?
Please Specify:
*Please select fundraiser:
How does supporting LOROS Hospice make you feel?

If you wish to support in memory of a loved one, please complete their name below (maximum of 60 characters)

Keeping in touch
We’d like to tell you more about our care for patients and their families, as well as how we spend our donations and updates on our work. We'll do this by post, but if you'd like to receive such updates via email please tick yes below (You can change your preferences at any time).

Sometimes we’d like to give you a phone call or send you a text message (SMS) too. If that’s okay, please tick yes below.

If you do not wish to receive any of this type of information, please tell us using the tick box below. We may still need to contact you for administrative purposes.

You can change your preferences at any time by contacting us at supportercare@loros.co.uk.

LOROS (including LOROS Enterprise and LOROS Lotteries) will only share your data with suppliers working on our behalf or if ordered to do so by law.

For details of what we do with your personal data, including your rights, refer to the privacy policy on our website www.loros.co.uk/privacy or contact us to obtain a copy. To contact our Data Protection Officer either email dataprotection@loros.co.uk, or write to LOROS Hospice, Groby Road, Leicester, LE3 9QE or call (0116) 231 3771.

Payment details
Bank details
LOROS
Groby Road
Leicester
LE3 9QE
DDLogo

Email: supportercare@loros.co.uk

For any queries, contact us on :
(0116) 231 8431


For your information

You will need your account details, which can be found on your cheque book or bank statement, to complete the direct debit instruction. If you require dual signatories to authorise a direct debit from your account please contact our fundraising team directly on (0116) 231 8431.



Fundraising Regulator Logo