We have tried to make our application process as simple as possible. There are two ways to apply, either via our online application form below or by downloading a Memorable Days Application Form and posting to us or by email to firstname.lastname@example.org
A reminder of our eligibility criteria can be found here
Find our address for postal applications here
Please complete all sections of the application form so we can process it as quickly as possible.
Preferred Contact Phone Number
Date of birth
Please provide a summary of what you would like your memorable day to consist of. Give as much detail as possible including where you would like to go, the type activity you would like to do, preferred dates and number of participants and their relationship to you.
Memorable Day Summary
Do you have any mobility issues, breathing difficulties, communication difficulties or dietary requirements that we need to know about when planning your memorable day?
Memorable Day Requirements
We want your memorable day to be fun and enjoyable, so we ask all applicants to be accompanied by a chaperone who understands your condition and circumstances and can assist you should it become necessary. This could be your partner, sibling, parent, relative, friend or child (if over 18 years).
Chaperone Title MrMrsMissMsOther
Chaperone First Name
Chaperone Last Name
Chaperone Contact Phone Number
Chaperone Date of birth
Relationship to applicant
As part of our eligibility criteria we require the details of your medical professional and a letter from them confirming your condition and care. This can be any correspondence you have already received from them dated within the last three months. Please upload a copy for our reference.
Professional Title DrNurseMrMrsOther
Professional First Name
Professional Last Name
Work Phone Number
Reference document 1
Reference document 2 (optional)
Are you happy for us to contact you about your application by? PhoneEmailPost
Are you happy for us to contact your medical professional to verify any information on this application, if necessary? YesNo
Would you like to receive information about our fundraising campaigns, events, ways to donate and service updates? YesNo
How did you hear about us? Medical ProfessionalWord of mouthCharity LiteratureCharity WebsiteSocial MediaOther
We understand that you may want to change your communication preferences in the future. To do this after we have processed your application and informed you of the outcome, you can update your preferences by contacting us as email@example.com.
I agree to the Data Privacy Statement
I, the applicant, by applying for a memorable day confirm that I have read, understood and accepted the terms and conditions herein. You may withdraw your application at any time by notifying us at firstname.lastname@example.org
I agree to the Terms & Conditions
Please contact us if you would like to know more about what we do and how you can get involved.
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