Question Title

* 1. Name of your company

Question Title

* 2. Address of your company

Question Title

* 3. Name of main contact for the £50 Challenge

Question Title

* 4. Email address of main contact

Question Title

* 5. Phone number of main contact

Question Title

* 6. How did you hear about the £50 Challenge

Question Title

* 7. Could you please let us know what your initial plans are for the £50 investment?

Question Title

* 8. By taking part in the £50 challenge you are pledging to raise a minimum of £200 for Saint Francis Hospice and promise to return the money if this amount is not reached.

Question Title

* 9. Would you like to be added to our monthly newsletter for our corporate supporters?

Question Title

* 10. Are you able to collect your £50 note from the Hopsice ? It can be collect any time between midday and 18:00 on Monday 13th January in the Education Centre at Saint Francis Hospice. If no, then we can arrange an alternative date for collection

T