Orpheus Musical Notes

Name: (required)

Address: (required)

Post Code :

Phone Number: (required)

Email: (required)

Your Note

Please choose your note:

£50 Single Note:£100 Double Note:

Would you like us to hang your note?

I’m happy for you to hang this note on my behalf.

Would you like to hang your note?

I would like to arrange to hang the note myself.

A note in memory of a loved one

Name to be engraved:

Date of Birth:

Date of Death:

Short message to be included on the note: (up to 25 characters including spaces) for example: ’Who loved Orpheus’, or ’We will miss you’.

A note in celebration

From:

Short message to be included on the note: (up to 25 characters including spaces)

Once created, your note will hang for a year, after which point we will contact you. Please allow around two weeks for you note to be created and engraved.

Your Privacy

The information provided by you in this form will be stored by the charity. Please tick the below checkbox to confirm you understand. Thank you. (required)

I understand

Thank you for completing this form. Once you click send you will automatically be redirected to our shop to make payment for the note of your choice. If you have any issues please contact [email protected].

Send