Use this form to notify the HLA of personnel changes.

We like to maintain the contact details of 2 people from each hospice. Subscription renewal notices will be sent to the primary contact. Please supply an alternative email address for subscription renewals if required.

Hospice / Lottery name*

Primary Contact

New Member Area login required?
Is this a replacement for someone who has left?
Who has left?

Secondary Contact

Name 2
Position 2
E-mail 2
Phone 2:
New Member Area login required ?
Is this a replacement for someone who has left ?
Who has left ?

E-mail for subscription renewals:
Use this area to notify us of other changes:
Show us you are human: