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Thank you for wanting to be a part of #Teamweald. To be considered for one of Hospice in the Weald’s charity places, please complete this form by February 1st.
Should you be successful we will contact you to confirm your place in the London Marathon. However, if we are unable to give you a place in the London Marathon we will endeavour to aid your fundraising journey and update you with other challenge events.
We ask that you pledge to raise £2500 to help raise vital funds for the Hospice in the Weald and continue providing outstanding care to our community. 

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* 1. Title

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* 2. First name

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* 3. Last name 

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* 4. Address:

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* 5. Postcode:

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* 6. Phone:

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* 7. Email:

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* 8. Date of Birth:

Date

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* 9. Occupation:

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* 10. Employer:

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* 11. Please tell us why you want to raise money for Hospice in the Weald team? Please give as much detail as possible.

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* 12. How much sponsorship do you aim to raise? What are your fundraising plans, (e.g. organising an event, work, friends and family, grant matching etc.)? Please give as much detail as possible.

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* 13. Have you participated in a marathon or other running event before? If yes, please give details.

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* 14. Does your employer have a matched giving scheme or any other charitable programmes that we could be nominated for? If yes, please give details.

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* 15. Would you be happy for us to share your story with local press and across our communication channels?

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* 16. Please select which size running vest you would prefer if successful:

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* 17. We provide #TeamWeald participants with iron-on letters for their vests. Please indicate which letters you would like.

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