Sponsorship Request

Names

First Last

Phone

Enter Email Confirm Email

Location of project

Organisation name

Registration Number

PBO number

Percentage African

Percentage White

Percentage Indian

Percentage Coloured

Beneficiary Demographics: Gender-Females

Percentage African Female

Percentage White Female

Percentage Indian Female

Percentage Coloured Female

Please provide an overview of the organisation for which you are requesting a donation/sponsorship.

Please give details of your sponsorship request (you may attach a copy of your proposal if you have one)

Donation value

How will you recognise Fuchs' contribution if you are successful in obtaining a donation/sponsorship? (required)

Please tell us about your corporate/organisational governance

Other information not included above you consider important to support favourable consideration of your request