Collections form

Thank you for choosing to raise money for Spinal Research. Your fundraising won’t just mean we can continue to fund our pipeline of research; it is also an investment in hope for a future where a spinal cord injury doesn’t mean a life sentence locked in paralysis.

Please take a few moments to tell us how you are planning on fundraising, and we will be in touch to help make your fundraising a massive success.

If you need any help completing the form or would just like a chat about fundraising you can contact us by email community@spinal-research.org or by phoning 0203 8247 400

Together, we will cure paralysis.

Your details

First Name

Last Name

Phone number

Address line 1

Town/City

Country

State

Province

County

Zip/Postal code

Date of birth

Fundraising details

How will you be fundraising?

I want to hold a collectionI want to leave a collecting tin at a fixed location

When are you planning on holding your collection?

Where are you planning to leave your collecting tin?

How many collecting tins do you need?

Are you fundraising for an event or challenge, such as the London marathon?

YesNo

Please specify which event/challenge.

Your connection to Spinal Research

Connection to Spinal Research

Injury level

Injury severity

How injury occurred

Year injured

Mobility impairment

Communication preferences

We would love to keep you up to date with all the latest Spinal Research news and information. If you'd like to receive our updates please let us know how you'd prefer to receive them:

Phone

Text message

By ticking the communication preference boxes, you are agreeing to join our contact lists. We'll only send you information related to Spinal Research. Your privacy is important to us and we process your personal data in accordance with the UK GDPR and our Privacy Policy. You can unsubscribe at any time. For more information about our privacy practices, please visit our website.

I understand that it is my responsibility to obtain written permission to hold my collection. I will ensure that I seek permission from the relevant site owners/owners and will seek advice if unsure. Where possible I will return the tin to Spinal Research within 3 months of any activity at my own cost

Contact Information