PLANT A VIRTUAL ROSE FOR EPILEPSY IRELAND Dedication Type*DonateSend a DedicationThis is a hidden FieldDonation Amount* Donation Choice€ 5€ 10€ 15€ 25€ 50OtherYour Name* First Last Your Email* Your Location*City and Country OnlyMessageWhy not share a message of support for Rose Week – it will be shown on our map!What county would you like to plant your rose in?*Choose countyAntrimArmaghCarlowCavanClareCorkDerryDonegalDownDublinFermanaghGalwayKerryKildareKilkennyLaoisLetrimLimerickLongfordLouthMayoMeathMonaghanOffalyRoscommonSligoTipperaaryTyroneWaterfordWestmeathWexfordWicklowRecipient Name*Recipient location*Please be as specific as possible with recipient location to ensure visibility or move the pin on the map?Recipient Email* We will notify your special someone that you have turn ireland purple in support of EpilepsyWhere did you hear about our Rose Week ® Campaign?Choose an optionSocial MediaEpilepsy Ireland websiteNewsletterPostWord of Mouth (Through a friend/family member)OtherHow did you hear about our SendLove Campaign? : Other*Epilepsy Ireland would like to occasionally contact you to provide updates and let you know how you can support our mission. Please use the options below to select how we can interact with you. You can withdraw your consent at any time. Your data is processed as per our privacy policy and please see www.epilepsy.ie/privacy-policyOpt-in to receive email communications from Croí. You can unsubscribe at any time. Opt-in to receive email communicationsCredit Card* Address ZIP / Postal Code
