OXPIP Supporter Contact and Consent Form Thank you for your interest in joining our OXPIP community, please complete this Contact and Consent Form and we will be in touch shortly. OK About You OK Question Title * 1. Please enter the following details Full Name Address Address 2 City/Town Postal Code Email Address Phone Number OK Your Contact Consent OK Question Title * 2. I am happy to be contacted by OXPIP regarding charity news and initiatives Yes No OK Please be aware that your contact and personal information supplied to OXPIP is stored securely electronically. By providing us with your email address you are agreeing to us to contact you by email. We will use these details to circulate information on OXPIP news, events and fundraising projects only. Should you wish to be removed from this mailing list at any time, please email development@oxpip.org.uk. The OXPIP Privacy Notice can be found at oxpip.org.uk/privacy-notice OK Question Title * 3. By checking this box and typing my name below, I am electronically signing to give my consent Yes No OK Question Title * 4. Please enter your name below to electronically sign OK Ways To Be Involved OK Question Title * 5. I am interested in: Receiving the OXPIP Newsletter Attending OXPIP fundraising events Supporting us with organising OXPIP fundraising initiatives Making a single or regular donation to enable our Parent-Infant Therapy provision in Oxfordshire Becoming an OXPIP Ambassador to help us raise awareness about OXPIP Becoming a Member of OXPIP to support OXPIP’s aims and objectives OK Thank you for your support! OK DONE