Challenge Event Application Form (Charity Place)

The event
Which skydive are you interested in?*
How did you hear about the skydive?*
If other, please give details.
Have you supported St John’s in the past?*

YesNo
If so, thank you so much! Please let us know how you supported us?
What is your T shirt size?*

SMLXL
Your fundraising

We require you to agree to fundraising a minimum amount to secure your place on Team St John’s. This amount will always exclude Gift Aid.
Are you fundraising in memory of a loved one?*

YesNo
If yes, please let us know their name and their relation to you.
How do you hope to raise the fundraising target?*
Do you think you could raise more than the fundraising target?*

YesNo
If so, how much?
Does your employer operate a matched giving scheme? i.e. whatever amount of money you raise your company will double or make a contribution.*

YesNo
Your details

Please let us know your personal details. We will use this information to contact you about the outcome of your application.
Your name*

TitleFirst nameLast name
Email*
example@example.com
Mobile*
Please enter a valid mobile number.
Telephone
Please enter a valid mobile number.
Address*

Address Line 1

Address Line 2

CityCounty

PostcodeCountry
Date of birth*

DayMonthYear
Keeping in touch

We want to reach, connect and support more people, ensuring that everyone in our community can live well for as long as possible. We can’t do this without the help of our supporters and volunteers, which is why we’d like to keep in touch with you about our work, news and the various ways you can support us. Please confirm below what you would like to hear from us about and how you would prefer to be contacted.
I am happy to be contacted by email:*

YesNo
I am happy to be contacted by post:*

YesNo
I am happy to be contacted by phone:*

YesNo
You can change the way you hear from us at any time by emailing us or calling 020 7806 4011. Please also see our Privacy Policy for how we collect, use and look after your information.
Terms and conditions

Please confirm that you have read and understood the terms and conditions for the event and would like to apply to skydive for St John's Hospice.
Signature*
Date*

DayMonthYear
Date
Should be Empty:

The event

Your fundraising

Your details

Keeping in touch

Terms and conditions