All we need are some details to send you your fundraising pack via email and set you up with your fundraising page to raise money online. Please fix the errors highlighted in the form. Title - Select - Mr Mrs Ms Miss Dr First Name Last Name Date of Birth Day Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Year Year 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 Email address Address Line 1 Address Line 2 Address Line 3 Town/City Postcode Stay in touch Become part of the movement to bring forward the day when all cancers are cured. Hear about our latest breakthroughs, campaigns and how you can help support our life-saving work via email. Yes please, opt me in No thanks, opt me out You can change your mind at any time by contacting us on 0300 123 3379 or preferences@cancer.org.uk To make our fundraising efforts targeted and effective and understand how much you may be able to give, we may research you using publicly available sources, for example public registers, corporate websites, the news or social media. Find out more in our Privacy Policy. We also may try to obtain up-to-date contact details for you using external sources such as 3rd party organisations (if you previously provided consent to share your data), or the post office national change of address database if you move house or change number, so that we can stay in touch. If you don’t want us to do this in relation to you, you can tell us anytime by contacting 0300 123 3379 or preferences@cancer.org.uk Personal Declaration By signing up I confirm that the above details are correct and that I have read and agree to the challenge rules. The Fundraising Regulator also encourages you to read and become familiar with the Online Fundraising advice and guidance for the public. Fundraising Regulator Terms and conditions Tick here to confirm that you have read this. Everything seems to be ok. Please submit when you are ready.
