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Fundraiser's name*

TitleFirst NameLast Name
Which of the following best describes your potential support?*

FundraisingGiving us your timeOffering your goods or servicesOther
How much do you hope to raise?*
GBP £
Email Address*

Confirmation Emailexample@example.com
Phone Number*
Format: 00000 000000.
Which Hospice cause are you supporting?*
Please tell us about what you are doing to support or fundraising for us*
What is your inspiration?*
What are you looking forward to the MOST about the activity?
Do you have any prior concerns about the activity?
We are so very grateful for the support and generosity of people like you. Can we share details of your story to inspire other supporters and fundraisers?*

YesNo
Which of our following channels are you happy for us to share details of your story on? You can make more than one selection.*

Social MediaWebsiteInTouch NewsletterExternal MediaPlease do not share
If your activity has already commenced, do you have any photos that you would like to share with us?

Please note that we may include some of these on our social media or website as part of your fundraising story.
Cancelof
Would you like to know more about us and ways you can support us?
I would like to receive communications via the following channels from Hospice Isle of Man about how my donations make a difference and the other opportunities that I have to provide support such as events, competitions, promotions and fundraising activities.

EmailSMS text message
You can change your preferences or opt out of receiving communications at any time by contacting us on 01624 672222. Our Privacy Policy provides more information about how and why we use your personal data.
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