Charity Nomination

Your Details

Name(Required)

First Last

Email(Required)

Phone Number

Charity Info

Charity Name(Required)

Website

Have we supported this charity in the past?(Required)

Yes

No

Hidden

Number

Please enter a number from 1 to 30.

Is charity on JustGiving?(Required)

Yes

No

Is charity registered?(Required)

Yes

No

Charity Number

Reasons for nomination

Why you have nominated this charity & how will the funds be used.

Why this charity?(Required)

How will the funds be used?(Required)

Upload Files

Upload files/photos to supplement your nomination.

Drop files here or

Accepted file types: jpg, png, pdf, doc, docx, avimov, Max. file size: 60 MB.

Charity Contact Details

Please click yes if you have ANY details about the charity. We would be grateful if you could try and find these to help us. The more info you can give will help us to make the most of your nomination.

Do you have any contact details for the charity?

Yes

No

Charity Contact Name

First Last

Charity Contact Phone Number

Charity Contact Email Address

Office Address

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Office Location

Phone

This field is for validation purposes and should be left unchanged.

Your Details

Charity Info

Reasons for nomination

Charity Contact Details

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