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Adviser Company*

Adviser Name*

Adviser Email Address*

Adviser Phone Number*

Money Laundering Checks Complete*

Which custodian will the Charity Foundation be held with?

Chosen Charity Foundation Name*

Does the client require philanthropic advice?

What purposes interests the donor?

Are there any charities the donor would like to give grants to?

How frequent does the donor wish to give grants?

Donor First Name*

Donor Last Name*

Donor Date of birth*

Donor Nationality

Address Line 1*

Address Line 2

City / Town*

County*

Postal Code*

Country*

Phone 1*

Phone 2

Email Address*

Occupation/Business

I want to Gift Aid my donation and any donations I make in the future*

Amount of First Donation*

Frequency of Donation *

Are there any Additional Grant Representatives?*

Is there a Successor?*

Will your client be happy to sign the application form electronically?*