Monetary donations are given to local good causes in A.F. Blakemore & Son Ltd’s trading area, to support of a variety of requests such as specialist equipment, community events and ongoing charitable work.

Please allow eight weeks for applications to be processed. 

Date of application:
*

Full Name:
*

Telephone Number:
*

Address:
*

Postcode:
*

Email Address:
*

Confirm Email Address:
*

Name of charity/organisation that the donation will go to (including charity number if applicable):
*

How did you hear about us:
Employee Friend of Employee Customer Search Engine Other *

If other please specify:


Please give a brief description of the charity/organisation you you would like to support:
*

Please write 50 words to explain how the donation will be spent and the donation size desired:
*

Donations can be awarded via two payment methods. Please complete the most suitable method below only.

BACS donation to a nominated organisation or charity bank account.

Bank account name:


Bank account sort code:


Bank account number:


Bank account address:


Cheque donation to a nominated organisation or charity. If you can, please avoid this option as it is not as environmentally friendly as BACS donations.

To receive a donation via cheque, please declare who the cheque should be made payable to:


Cheque donations awarded must be banked within six months of issue date to be valid.

Please note that we will retain your details for up to 10 years, after which they will be deleted.