If you are interested in displaying one of our collection tubs then please complete the form below:

Required
Required
Required
Address
Is this a company/school address?
Are you happy to be contacted by post?
Required
Required
Required
I am happy to be contacted by telephone

Terms and conditions

I accept responsibility for my ELHT&me collection box. I undertake to use the collection box solely for the benefit of the East Lancashire Hospital Trust Charity (registered charity no. 1050478). I will return said box to the charity when the activity is complete, or when requested to do so by ELHT&me charity. I agree to abide by the statutory Laws regarding the Collection of Monies for their charitable purposes. I am 16 years of age or over.

Required

Data protection

The charity will hold the information you give us for communication, marketing and administration purposes in accordance with the Data Protection Act 1998. If you do not wish to receive appeals from the charity in the future, please call Denise Gee 01254 732140