Collection tin request

Thank you for your support of St Richard’s Hospice through having a static collecting tin on your premises. We are very grateful for your support and for helping us to raise funds and awareness in this way.

Due to regulatory changes under the Fundraising Code of Practice, we are obliged to have a record of your permission to have a tin at your premises.

For this reason we ask you to read the following information and complete the agreement below. Once the agreement is received, we will contact you to arrange delivery of a tin.

About you
Your name*
Prefix First Last
Business name
Your email*
Contact number*
Address where tin will be located*
Street Address Address Line 2 City ZIP / Postal Code
Contact preferences*
From time to time we would like to keep you up to date with our hospice news, events and activities. Please let us know the ways we can contact you. Tick the relevant options.
- Email
- Phone
- SMS
- None of the above
Agreement
Collection Tin Agreement*
I have read and agree to the collection tin agreement
I confirm that I am the Site Holder/Appropriate Contact and give permission to place a St Richard’s Hospice static collecting tin at my premises.

I am responsible for ensuring that I contact St Richard’s Hospice and/or the tin collection volunteer for the following reasons:
– If the tin is full and needs replacing
– If the tin has been tampered with in any way
– If the tin is lost or stolen, I will also inform the police

I agree that if I wish for the tin to be removed at any time, I will inform St Richard’s Hospice of my decision in writing, by post or email, and ensure that they are able to collect it in a timely manner so the vital funds collected reach St Richard’s Hospice.
If you want to change how we contact you, please let us know by completing a Change of Details form
View our Privacy Policy for more details.

About you

Agreement