Association of NHS Charities - Application Formv

If you have any questions relating to your membership or
the Association, please call or email:

Amanda Witherall
T 08454 635328
E amanda@assoc-nhs-charities.org.uk

* Please note that all these fields have to be filled in before
your application will be processed.

Once you have submitted your form we will
contact you to discuss your application further.

Charity name*
Charity number*
Charity income (for previous financial year)*
Primary contact*
Position*
Address Line 1*
Address Line 2
Town/City*
County
Postcode*
Email *
Telephone*
Fax
Chair of Charitable Funds Committee
Chair's email
Chief Executive’s name
Chief Executive’s email
Fundraising contact's name
Fundraising contact's email
Fundraising contact's telephone number
Please type this number*