Fundraising information pack registration form

Contact person title*:
Choose... Mr Ms Mrs Miss Doctor

Contact first name:*

Contact last name:*

Choose a password:*

Repeat password:*

Name of group/organisation (if applicable):

What kind of Get together event are you interested in? *:
Get dining Get dunking Get dancing Get dressing Other/not decided (please specify below)

Date of planned Get together (if known) (must be DD-MM-YYYY format)

Please tick box if you would like us to send you a Get Together fundraising pack in the post

Address line 1*:

Address line 2:

Address line 3:

City/Town*:

County (not required if City is London)*:

Postcode*:

I would like to receive information and hear about other ways to support Guide Dogs by email

Contact email address:

I would like to receive information and hear about other ways to support Guide Dogs by telephone

Contact telephone:

Best time/method of contact?:

How did you hear about fundraising for guide dogs?:
Choose... Giving magazine Forward magazine Puppy Times publication Other newspaper/magazine Get together leaflet Word of mouth Guide Dogs website Guide Dogs email Guide Dogs branch Guide Dogs speaker Facebook Flickr Twitter Sainsbury's magazine WI Virgin Media Magazine Volunteering bureau Other (please specify below)

We would like to keep you informed about Guide Dogs, its activities and other ways in which you can support us. If you do not wish to receive this information, please tick this box