Collection Box Request

Mite Box Request Form
Please fill in the form below and click on the submit button to request a Mite Box:
NB: You will also need to send a letter back to the Hospice confirming that you have received (a) St. Francis Hospice Mite Box(es) and that I am responsible for the return or arranging the return of the Mite Box(es) and contents to the Hospice at the appropriate intervals - Details are outlined below.