Making a personal donation?

Thank you for raising money for us

Thank you for choosing to fundraise for Dementia UK by taking part in an event or organising a collection. Please provide your contact and payment information below.

If you've already let us know about your fundraising activity, please enter the same contact details you used when you registered.

* = required fields

* required

I'm paying in money I raised myself
I'm paying in money on behalf of a group or organisation

* Title:
* First name
* Last name

Contact details



Enter address manually
* Address 1
Address 2
* City/Town
* Country
* * County
* Postcode
Phone number	( )
* Email address

Your fundraising

* How did you raise the money?

Please provide a brief description of your activity e.g. bake sale, sponsored walk etc.

Keeping you updated

It’s only with support from kind people like you that we can be there for families living with dementia across the UK. We would like to keep in touch and update you with the latest behind the scenes news, including the incredible difference our specialist Admiral Nurses make, and how you can help us to continue our long term work by fundraising and volunteering for us.

If you would like to change how you are contacted by us, simply contact our Supporter care team on 0300 365 5500 or email supportercare@dementiauk.org

Your privacy

Dementia UK will collect personal data from you whenever you order information or goods, use our services or make a donation. We will only use it in ways you would reasonably expect or have agreed to but we may supplement it using publicly available information, and we may analyse it to ensure that we are sending you only the most relevant material, which helps keep our costs down. We use strict security features to keep your information safe and we will only share your details with trusted suppliers acting on our behalf.

For further information about how we protect and use your data please see our privacy policy at www.dementiauk.org/privacypolicy

Yes, I’d like to receive email updates
Yes, I’d be happy to receive updates by phone
Yes, I’d like to receive text message updates
No contact via post please

Please provide the name of the person being remembered

Please tell us which event you took part in

Please give details

Payment details

Pay using Card
Card Security Number is not supported in data entry. To process a credit card payment, you need to disable Card Security from the Electronic Payment page in the Configuration tab.
Payment Method:	One Time Payment Credit Card
* Please enter the amount you're paying in
* Processing Date:
* Number of Installments:
	installments
Pay using PayPal
* Card Type
* Card number
* Card security number	Where is my card security number?
* Cardholder's name
* Card expiry date
Start Date:
OR Issue Number:
* Bank Name:
* Bank ID:
* Cheque No.:
* Transit No.:
* Account No.: