Change your details or cancel your membership

If you feel you have a problem with any kind of gambling and would like to self-exclude from our Hospice gambling activities, please click here.

Do you wish to change your details or cancel your membership?
Your previous details
Name
First Last
Membership number
Email*
Address*
Street Address Address Line 2 City County Post code
Your details
Name*
First Last
Membership number
Email*
Address*
Street Address Address Line 2 City County Post code
Your new details
Please use the fields below to notify us of any changes in your personal data.
Name
First Last
Email
Phone
Address
Street Address Address Line 2 City County Post code
Please tick the following box to verify your submission
Protecting your data
At St Nicholas Hospice Care protecting your data is very important to us, and we want to make sure you are receiving information from us in a way that suits you.
If you wish to read more about how St Nicholas Hospice Care uses and protects your data, please visit https://stnicholashospice.org.uk/yourdata.
Name
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Your previous details