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. 

Upon submission of your application, you should receive a confirmation email.

If you have not received a confirmation email within an hour of submitting an application it is likely that your application hasn't been received.

Please either try resubmitting your form or get in touch for further assistance: 0121 568 2910 / .(JavaScript must be enabled to view this email address). 

 

Date of application:
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Full Name:
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Telephone Number:
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Address:
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Postcode:
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Email Address:
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Confirm Email Address:
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Name of charity/organisation that the donation will go to (including charity number if applicable):
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How did you hear about us:
Employee Friend of Employee Customer Search Engine Other *

Please give a brief description of the charity/organisation you you would like to support:
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Please write 50 words to explain how the donation will be spent and the donation size desired:
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Donations are awarded via BACS payments. Please complete the below details.

BACS donation to a nominated organisation or charity bank account.

Bank account name:
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Bank account sort code:
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Bank account number:
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Bank account address:
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Please note that we will retain your details for up to 10 years, after which they will be deleted.