EmailMe Form - East Leake Traders Association

1. Name of your organisation *

2. Name of your main contact *

3. Position held *

4. Postal address of contact person *

5. Mobile telephone number *

6. Landline telephone number *

7. Email contact *

Confirm

Are you a: *

Registered charity

Community group

Other (please specify below)

Details if not charity or community

9. If registered charity: Charities Commission number

10. Amount requested *

£ Pounds

11. Date required (if applicable)

DD / MM / YY

12. What are the main activities of your group or organisation? *

13. Where do you operate from? *

14. What year was your organisation set up? *

15. Organisation bank details *

1 / 3