Name*
Company Name
Address*
Postcode*
Your Email*
Phone*
Web site
Description* Please tell us what you would like us to do
Benefits* Describe the benefits of doing the work would be to your organisation or community
Help & assistance* Please list any volunteers, materials, tools or equipment you could offer to the project
By submitting this application, I confirm that the facts set forth are true and complete. I understand that if this proposal were accepted, any false statements, omissions, or other misrepresentations made on this application may result in the project being cancelled at any time. By submitting this application, I give permission to www.lovestoke.org to publicise the project. Accept
