Corporate Volunteering Register Your Details

Name*

Title First Last

Name of company*

Date of corporate volunteering at Havens Hospices*

Address*

Street Address Town/City Postcode

Telephone number

Mobile phone number

Personal email address

Date of birth*

We need this for insurance purposes

Emergency contact name*

Emergency contact telephone number*

Relationship to you*

Please tick to confirm you are fit and well to carry out physical activities*

Yes, I am
No, I am not

Please advise of any medical conditions or medication that you feel we should be aware of; this will help us to ensure your safety whilst you are volunteering.

Do you have any dietary requirements for lunch?

Volunteering on the day at Little Havens

Do you have any specific skills which could be utilised for one of our maintenance projects?

Can you support Havens Hospices in the future?

If you tick YES for any of the below you will be contacted by a member of our Fundraising team who will provide you with full details.

Would you like hear more about Volunteering for Havens Hospices?

Yes, I'd like to know more about volunteering
No

Would you like to organise a fundraising event for Havens Hospices in the future?

Yes
No

Would you be interested in running the London Marathon for Havens Hospices?

Yes, I'd like to find out more
No

Are you interested in doing a Skydive, Wing Walk, Walking or Cycling challenge?

Yes, I'd like to find out more
No

How can we contact you?

You’re in charge of what information Havens Hospices has about you, and what you want to receive from the charity. Everything is laid out in our Privacy Policy which you can read on our website. But you can change how we contact you by emailing changeme@havenshospices.org.uk, visiting www.havenshospices.org.uk/update or calling 01702 220345.

I'm happy for Havens Hospices to contact me by:

email
phone
post