Test page

Please do not place your order on this page as it is used for testing purposes only

'Remember Me' rose dedication form

Please complete the order form below to be part of this special art installation remembering our loved ones

Please select your rose colour(Required)
Use the space above to enter the name of the loved one you would like to remember. Please note that tags are limited to 12 characters and we politely ask that kisses are not added to the end.

Your donation

For each individually handcrafted rose, we suggest a minimum donation of £30. This will help cover the cost of the rose itself and ensure a donation to the hospice that will help care for someone living with a terminal illness.

Gift Aid

Please let us know how we can use the telephone number you have provided
Please let us know how we can use the email address you have provided