Fundraising Form

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Your details

Title

Name

First

Last

Phone

Date of Birth

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Fundraising

What best describes your fundraising activity? (please choose one)

I am interested in...

Support a particular department/appeal

I wish to support a particular hospital/department/appeal. – expands into a free text box which dept./appeal etc. (please specify below)

How much are you hoping to raise?

When do you plan to do your fundraising or hold the event?

Previous fundraising

I have previously fundraised for Barnsley Hospital Charity

If you have a fundraising page please enter the URL below.

If you’re fundraising through JustGiving, don’t forget to link to our page.

Tell us about your fundraiser

We would love to hear more about what you have planned, why you are doing it and any special stories you would like to share

Please provide details...

Would you like a Barnsley Hospital Charity representative to attend your event?

Yes, please
No, thank you

Please note this isn’t always possible, but do ask if you would like someone to attend, and we’ll get back to you.

Would you like a 'letter of authorisation'?

Yes, please
No, thank you

A letter from us acknowledging your fundraiser can be useful if you are asking for raffle prizes and other support.

Calendar entry

I am happy for details of my fundraising event to appear on Barnsley Hospital Charity's fundraising calendar

Declaration

Compliance with fundraising laws

I confirm all funds are voluntarily given and accepted without expecting or receiving something in return. I confirm I will comply with the fundraising laws and recognised fundraising standards when organising any fundraising activities. I hereby declare that all personal information is voluntarily given and is accurate to the best of my knowledge.

Contact consent

I confirm Barnsley Hospital Charity can contact me about my fundraising via the details I have provided in this form.

For more information about how your data is stored please see our privacy policy. You can change your preferences at any time by emailing barnsleyhospitalcharity@nhs.net

fundraising describes would

Communication

I agree to receive Barnsley Hospital Charity’s newsletter to my email address so I can find out how my support helps patients and staff across the Northern Care Alliance. I understand I can unsubscribe at any time by emailing barnsleyhospitalcharity@nhs.net

I would like to hear about other ways I can support the charity via:

Email
Phone
Post

GETTING INVOLVED

FUNDRAISNG FORM

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Your details

Fundraising

Tell us about your fundraiser

Declaration

Communication

ENABLING OUR NHS TO GO THAT EXTRA MILE

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Getting involved

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