Register Here!

Fill in your details 👇 and we will get your Independent Age t-shirt to you when you receive your first donation🏆

T-Shirt Size*

First name

Last name

First line of address

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Second line of address (optional)

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City or Town

County

Postcode

Phone

We are always looking for real life stories to share on social media and on our website. Would you be happy for us to share your story?*

Date of Birth

E-Mail

We want to make the UK the best place to grow older and would love you to be involved. How would you prefer to be contacted?

E-Mail

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By submitting the above information you are agreeing to us using your data to process your fundraising. Please see our privacy policy for more information. We will send out your top once you've set up your Facebook Fundraiser page and received your first donation.