Shine A Star for the Mercy

From: (If you wish to remain anonymous please leave blank)

Who would you like to dedicate the star to? *

E-Mail *

Email Again *

Title *

First Name *

Surname *

Address Line 1 *

Address Line 2 *

Address Line 3

Town/City *

County *

Country *

Phone number (no spaces) *

Work of the Mercy

Would you like us to keep you updated about the fundraising appeals of the Mercy Hospital Foundation? Tick or untick the boxes as you wish.

I'd like to be updated by post *

(we have just two mail campaigns a year)

Yes

I'd like to be updated by phone *

(we will never phone you more than three times a year)

Yes

I'd like to be updated by e-mail *

(we can send you our monthly e-zine with updates, stories and more)

Yes

You have ticked NO to all communications.If you would like to receive emails about this event only from The Mercy Foundation please tick your choice below *

Yes, I am happy to receive emails about this event only

No, I do not want to receive any communications at all from The Mercy Hospital Foundation

Data Protection

(please note, you can contact us to change your communication details by ringing 021-4274076, emailing christine@mercyhospitalfoundation.ie or writing to 26 Henry St, Cork. Our full Data Protection/Privacy Policy is available by click here)

Shine A Star for the Mercy

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