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  • Online Charity Request Form

     Name of the Charity you are raising funds for:  
     * Registered Charity number:  
     * Address of the Charity:    
     * Postcode of the Charity:  
     * Address of the venue:    
     * Postcode of the venue:  
     * Date of fundraising event:  
     Further details regarding the fundraising event:    
     * Your First Name:  
     * Your Last Name:  
     * Address:    
     * Postcode:  
     * Contact telephone number:  
     * Email Address: