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CHARITY REQUEST FORM
BIRMINGHAM CITY FOOTBALL CLUB

1.

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* 1. Name of charity/community organisation:

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* 2. Registered charity number (if applicable):

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* 3. Address of charity/community organisation:

Street 1

Street 2

City

County

Postcode

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* 4. Venue address of fundraising event:

Line 1

Line 2

City

County

Postcode

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* 5. Date of fundraising event:

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* 6. Further relevant details regarding the fundraising event (e.g. amount of money hoping to raise):

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* 7. Your contact details:

Name:

Address:

Email:

Phone: