Fundraiser Registration Form

Fundraiser Registration Form
Thank you so much for fundraising for Dorothy House Hospice Care! So we can best support as you take on a challenge or host an event, we'd love to know a bit more about you and your fundraising plans. With this in mind, we kindly request you complete our registration form below. Any questions on the form, please don't hesitate to reach out on 01225 721480 or email communityfundraising@dorothyhouse-hospice.org.uk
Your Details
Name*

TitleFirst NameLast Name
Email*
Address*

Address Line 1

Address Line 2

TownCounty

Postcode
Phone Number*
If you are running this fundraiser in connection with a business or community group, please tell us the name of that business or group
Your Fundraiser Details
Name of your fundraising event/challenge*
What inspired you to take on this fundraising challenge or event?
Date of your fundraising event/challenge*

DayMonthYear
Date
If your fundraiser runs for multiple days, please let us know when it ends too

DayMonthYear
Date
Where is this event or challenge taking place?*
What fundraising target do you have in mind?*
Please share a few more details of your event/challenge including how you plan to raise funds, such as donations, ticket sales, raffle, sponsorship.
If you have already created an online fundraising page (e.g. JustGiving/Enthuse/etc.) please provide the link here
Are you fundraising in memory of someone?*

YesNo
If yes, please could you tell us their name?
What was your relationship to them?
Support we can give
We have a range of materials we can provide to support you with your fundraising, please tick all that you would like

Collection BucketCollection BoxHandheld FlagsLarge Vinyl BannerOur "In Aid Of" logo to add to promo materialsOutdoor Teardrop FlagSmall Cardboard Collection BoxSponsorship FormT-shirt (cotton)T-shirt (running tech)Vest (running tech)Information about GiveTap, a contactless donation app to help with card payments
Please provide any other information about your request, including quantities and sizes (S/M/L/XL/XXL/3XL) of anything listed above
We are able to send staff, or volunteers, to an event to represent Dorothy House. They can say a few words, speak about the work of the charity and take part in a cheque presentation. If this is something you would be interested in, please provide more details about what you might require below e.g. date, time, length of talk required, etc.
Your personal details will be stored on our internal database, which allows us to contact you by post about Dorothy House Hospice Care's crucial work, campaigns and events, as well as ways you could get involved and provide support.
If you would prefer not to receive information by post, please tick the box.
Additionally, we would like to record your communication preferences for receiving information about Dorothy House Hospice Care's crucial work, campaigns and events. Please could you let us know the most appropriate methods by ticking Yes or No to each:
Email

YesNo
Phone

YesNo
Text

YesNo
You can update any of your communication preferences by visiting our webpage dorothyhouse.org.uk/staying-in-touch-with-you/ or by phoning 01225 721 480. Our privacy statements explain how we handle your data. You can find these at: dorothyhouse.org.uk/privacy/
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Fundraiser Registration Form

Your Details

Your Fundraiser Details

Support we can give