What is the name of your suggested charity?

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* 1. What is the name of your suggested charity?

In which area(s) does this charity primarily operate?

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* 2. In which area(s) does this charity primarily operate?

  Primary Involvement Also Involved In
Animals
Arts, Culture, Humanities
Education & Research
Environment
Health
Human Services & Community Development
Human & Civil Rights
International (inc. disaster relief)
Are there any high profile supporters of this charity who you're aware of? If so, please list any and all below.

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* 4. Are there any high profile supporters of this charity who you're aware of? If so, please list any and all below.

What is the nature of your connection to this charity? (You can pick more than one answer)

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* 5. What is the nature of your connection to this charity? (You can pick more than one answer)

Please fill in your details if you would be happy for us to contact you with regard to facilitating an introduction to the charity:

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* 6. Please fill in your details if you would be happy for us to contact you with regard to facilitating an introduction to the charity:

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