THE IPSWICH HOSPITAL CHARITY

Thank you for choosing to organise your own fundraising event or activity for The Ipswich Hospital Charity. Please tell us a bit more about you and your event so that we can provide the support and fundraising materials you need.

Please complete this form electronically and email to the Head of Fundraising . Please see the Explanatory Notes before completing this form.

No commitment to fundraising should be made until approval has been given by the Head of Fundraising.

Please note, approval to fundraise for a particularWard or Department Designated Charitable Fund, does not legally restrict the Trustee’s discretion to apply the fund.

CF8b – FUNDRAISING AUTHORISATION REQUEST FORM

SECTION 1:
Full name of lead fundraiser:
Contact telephone:
Email:
Address & Postcode
Date of Application:
Name of Ward or Department you wish to fundraise for:
SECTION 2: Proposed Fundraising
Description of Proposed Fundraising Activity
Date of Event or Activity:
Do you intend to approach the public or local companies to raise funds? If so, please provide details
How much do you hope to raise? / £
Do you intend to use any Ipswich Hospital NHS Trust resources e.g. corporate logo, equipment, uniforms, premises etc.? Please specify.

We will use your details to contact you regarding your fundraising activity. Please see our Privacy Policy for more information on how we use your information.

By completing and submitting this form you consent to us contacting you from time to time to keep you up to date about how we spend the money our supporters raise and how you can get involved in our activities including fundraising. We will not sell or share your information with any other party.

You can change the way we communicate with you at any time by emailing us

For Official Use Only

Date Received:
Proposal Accepted/Rejected
Reason for Rejection

The Ipswich Hospital NHS Trust Board, as Trustee of the Ipswich Hospital Chatity, is responsible for ensuring that:

a)Fundraising is properly carried out;

b)Expenditure is properly validated;

c)All funds raised are properly accounted for;

d)The costs of fundraising are not excessive.

In order that these conditions are achieved, the Trust has appointed a Head of Fundraising to deal with all matters relating to fundraising. The aim of this Form is to eliminate fundraising taking place on behalf of The Ipswich Hospital Charity, which the Trust has no knowledge of. The Trust needs to ensure that its name, trademarks/logo will not be exploited, which will in turn damage the Charitable Fund.

In completing this Form, the following requirements must be met:

  1. No fundraising should take place in the Trust’s name until approval has been given by the Head of Fundraising
  2. It is not Trust policy for undischarged bankrupts to fundraise on behalf of the Trust.
  3. The Trust reserves the right to request fundraisers records of income and expenditure in relation to the event upon giving one months’ notice.
  4. The approval to fund raise is purely a notification that the Trust is aware of the event(s). It is NOT an indemnity to the fundraiser nor their creditors/suppliers that the Trust will meet the expenditure associated with any events should proceeds not cover this. These together with obtaining the correct licences and permissions and maintaining public and event liability insurance for the named activity remain the responsibility of the fundraiser.

CF8b – External Fundraising Request FormDec 2016