We would be grateful if you could please check the information below.

If you are happy with the answers you have provided, please click 'Complete' to submit your application.

If you would like to change any answers, please click 'Revise'.

Thank you.

*First Name:
*Work Email:
*Work Contact No:
*Please confirm which brand you most associate yourself with in your role:
*Please choose a category that most closely describes the beneficiaries of the charity:
*Please confirm your Retail Area or the office site that you are based in:

Branch and agency colleagues please choose your Retail Area/Region. - Office site colleagues please confirm the site you work from e.g. Office Site - Charlton Kings.
*Your branch, agency or department:
*How did you hear about the Charitable Foundation?
*If you would like to join the Small Change Big Difference scheme, please provide your account number(s) here:
Please enter 'N/A' if this question is not applicable to you.
*Charity Name:
*Registered Charity No:
*Charity Contact Email Address:
We require the email of the Fundraiser, not the generic email address of the charity
Charity Website:
*Contact name at the charity:
*Charity Address Line 1:
Charity Address Line 2:
Charity Address Line 3:
*Charity Post Code:
*Which part of the UK does the charity operate? 
*Improving Health/Saving lives and Alleviating Poverty are the main aims of the Charitable Foundation, which one of these does the charity focus on?
*Please provide us with details of the project/item(s) you are applying for?
Include information of what the charity will purchase with a donation and how this will help their beneficiaries
*How much are you applying for?
Please note that the maximum donation amount is £2,000.00
*How many individual people would directly benefit by this donation over the next 12 months?
How many beneficiaries from the charity would benefit by this donation?
*What is the nearest town/city that would benefit from this donation?
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