Please ensure all fields have been completed before submitting this form.


Trader ID *
Trader Name *
Email Address *
Charity Name *
Registered Charity Number *
Charity Contact Name *
Charity Website *
Charity Email Address *
Address of Charity *
County Area for the Charity *
If 'Other' Please categorise
Charity Mission Statement *
(Please cut and paste from website)
Use of funds *
Please outline previous or current fundraising
you have undertaken with your nominated charity,
providing dates and amounts raised. *

Security test. Please identify the pictures:*

   

Please ensure all fields have been completed before submitting this form.