• Thank you for responding to our Light up a Life invitation - please complete the form below. If you have any questions please contact our dedicated Customer Experience Team on 01372 461808 or customerexperience@pah.org.uk

    Fields marked with * are mandatory to complete.

  • Personal details

    To be able to identify you on our system please input your details:

Experiencing difficulties?

We're here to help so please don't hesitate in contacting us:

01372 461808

Available Monday – Friday 9am till 5pm, closed Bank Holidays

Security & Privacy is important to us

We use secure transmission and never share, sell, swap or rent your data to third parties for marketing purposes.

We are committed to protecting your privacy and will only use personal data that we collect in line with all applicable laws, including the General Data Protection Regulation (GDPR).