Create a Memorial

An in memory page can be set up in the name of a loved one who has passed away and will be a lovely tribute to their lives.

Once you have set up the in memory page you will have an online memorial where you and your family can share your thoughts and feelings as well as memories about your loved one. You also have the ability to share photos and videos, as well as collecting donations for Alzheimer’s and Dementia Support Services in memory of them.

It is very easy to create the page, simply fill in the form below. If you need any help in completing the form please call Ese on 01474 533990 who will be happy to assist.

Name of who you are remembering

A description of what they meant to you and how you would like them to be remembered

Date of Birth (DD/MM/YYYY)

Date of Death (DD/MM/YYYY)

Which appeal would you like to fundraise for?

Please upload a great picture for the top of your page.

First Name

Last Name

Keeping In Touch

We'd love to keep you posted with our news, activities and how you can help in other ways. We'll never sell or swap your details with anybody else. You are free to change your mind at anytime. Please indicate how you would like to hear from us by using the tick boxes below

Via email Via telephone Via post

Your Privacy

We will always store your personal details securely. We'll use them to provide the service that you have requested, and communicate with you in the way(s) that you have agreed to. Your data may also be used for analysis purposes, to help us provide the best service possible. For full details see our Privacy Policy

By submitting this form you are agreeing to our terms and conditions

0147 453 3990