PSPA Online Join Us Form for Fundraisers
Once we have received your form one of our Fundraising Team will be in touch and you will also automatically receive our PSPA Matters Magazine and regular updates.
Contact Details
Salutation
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Dr
Miss
Mr
Mrs
Ms
Professor
First Name
Last Name
Preferred Name (nickname)
Address Street
Address Town / City
Address County
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Aberdeenshire
Aberdeen City
Argyll and Bute
Angus
Co Antrim
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Avon
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Bristol
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Caerphilly
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Cheshire
Clackmannanshire
Cleveland
Cumbria
Carmarthenshire
Cornwall
Conwy
Derbyshire
Denbighshire
Devon
Dyfed
Dumfries and Galloway
Dunbartonshire
City of Dundee
Dorset
Co Down
Co Durham
East Ayrshire
City of Edinburgh
East Dunbartonshire
East Lothian
East Renfrewshire
East Yorkshire
Essex
East Sussex
Falkirk
Co Fermanagh
Fife
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Guernsey
Glamorgan
Glasgow City
Gloucestershire
Gwent
Greater Manchester
Gwynedd
Hampshire
Herefordshire
Highland
Hertfordshire
Humberside
Isle of Man
Isle of Wight
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Jersey
Kincardineshire
Kent
Lancashire
Co Londonderry
Leicestershire
Lincolnshire
London
Middlesex
Mid Glamorgan
Montgomeryshire
Midlothian
Monmouthshire
Moray
Merseyside
North Ayrshire
Northumberland
Norfolk
North Lanarkshire
Northamptonshire
Neath Port Talbot
Nottinghamshire
North Yorkshire
Orkney Islands
Oxfordshire
Pembrokeshire
Perth and Kinross
Powys
Rhondda Cynon Taff
Renfrewshire
Ross and Cromarty
Roxburghshire
Rutland
South Ayrshire
Scottish Borders
Suffolk
South Glamorgan
Shropshire
South Lanarkshire
Somerset
Sark
Surrey
Sussex
Stirlingshire
Staffordshire
Swansea
South Yorkshire
Torfaen
Tyne and Wear
Co Tyrone
Vale of Glamorgan
Warwickshire
West Dunbartonshire
West Glamorgan
Wiltshire
Western Isles
West Lothian
West Midlands
Worcestershire
Wrexham
West Sussex
West Yorkshire
Yorkshire
Shetland Islands
Address Postcode
Email Address
Please provide either a mobile or home phone number.
Mobile Number
Home Phone
Preferred Phone
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Home
Mobile
How did you hear about PSPA
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E-Newsletter
Event
HSCP
Media
Other
PSPA Matters
Search Engine
Social Media
Website
Word of Mouth
Introduction From
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Choice A
Choice B
Choice C
Further Information
Sex
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Female
Male
Nonbinary
Not Listed
Prefer not to say
Unknown
Other
Pronouns
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He/Him
She/Her
They/Them
He/They
She/They
Not listed
Ethnicity
Please select...
Any other ethnic groups
Asian or Asian British - Bangladeshi
Asian or Asian British - Indian
Asian or Asian British - Pakistani
Asian or Asian British - Any other Asian background
Black or Black British - African
Black or Black British - Caribbean
Black or Black British - Any other Black background
Chinese
Mixed - White and black African
Mixed - White and black Caribbean
Mixed - White and Asian
Mixed - Any other mixed background
White - British
White - Irish
White - Any other category
Not Stated
Prefer not to say
Date of Birth
Your link to PSPA (if relevant)
What is your link with PSPA:
Name of your family member/friend who has PSP or CBD
You are their: i.e. daughter, nephew, wife etc.
What fundraising opportunities interest you?
Please tick all that apply:
Active challenges - e.g. walking, running, parachuting
Community fundraising - organise your own fundraiser in your community - e.g. coffee mornings, quiz nights, bucket collection.
Corporate fundraising - e.g. nominate us to be your company's charity of the year, give a company donation, encourage employees to fundraise for us, etc.
Leaving a gift in your Will
Ad-hoc donations and appeals
Regular giving - e.g. donating by monthly direct debit
Volunteering at events
Charitable Trusts and Foundations
Other
If you selected 'Other,' or have fundraising opportunites that interest you which are not listed, please share them here.
We are always keen to hear what our supporters are doing to raise funds for PSPA. If you would like to tell us about your fundraising plans, or
would like our advice and support with fundraising, please contact us at
fundraising@pspassociation.org.uk
, or call 01327 322414.
Communication Preferences
We would like to continue to keep in touch with you to tell you about the vital work we do for people with PSP or CBD, our fundraising activities, and opportunities to support us as well as the services we provide.
Please select all the ways you would like to be contacted:
I would like to receive communications by email
I would like to receive communications by post
I would like to be contacted by phone
No Further Contact from PSPA:
I do not wish to be contacted by PSPA
You can change your marketing options at any time by contacting us by email:
consent@pspassociation.org.uk
; telephoning us on 01327 322 410; or writing to us at PSPA, Margaret Powell House, 415a Midsummer Boulevard, Milton Keynes, MK9 3BN.
Registered charity number England and Wales 1037087 and Scotland SCO41199
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