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Who we are
Our vision
Our impact
Latest news
Blog
What we do
Ground-breaking research
Patient & family wellbeing
Staff wellbeing & training
Cutting-edge equipment
Enhancing buildings & spaces
Support us
Donate
Raise money for us
Remember your loved one
Leave a gift in your Will
Give a bigger gift
Events
Corporate partnerships
Share your story
For NBT staff
Your NHS charity
Apply for funding
Fundraise for your ward
Contact us
Search
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Virtual London Marathon 2022 Application Form
Apply to run the Virtual London Marathon for Southmead Hospital
Your contact details
Preferred Title
*
Mr
Mrs
Ms
Miss
Mx
Dr
Other / None
First Name
*
Surname
*
Email
*
Phone number (Mobile or Home)
*
Street Address 1
*
House/Flat Number and Street Name
Street Address 2
*
Area e.g. Southmead, Lockleaze, Southville
Town/City
*
Postcode
*
Running for Southmead Hospital
Why do you want to run and raise money for Southmead Hospital?
*
For example, do you have personal experience as a patient or has a loved one received care here? Tell us why you're passionate about Southmead Hospital!
What’s the longest distance you’ve run?
Please share a little information about your running ability.
Please confirm that you're committed to raise a minimum of £500.
*
Yes
No
Please provide details of how you plan to raise your sponsorship?
Where do you work? If your employer has a ‘matched funding’ scheme for your fundraising, please provide details:
Are you happy for your photo and story to be used online and in print by Southmead Hospital Charity and North Bristol NHS Trust?
*
We'll work with you to ensure you're happy with anything that we publish.
Yes
No
How did you find out about our Virtual London Marathon 2022 places?
Facebook
Instagram
Twitter
Website
LINK
From the Charity team directly
Word of mouth (e.g. a friend told you)
Contacting you
Southmead Hospital Charity email marketing
We'd like to email you about other ways you can help support the staff and patients at your local hospitals. Please tick the below box to hear from us via email.
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We would like to contact you in the future about the impact of your generous support. If you would prefer not to hear from us in the future, you can opt-out using the tick-boxes below.
No, I don't want to be contacted by post
No, I don't want to be contacted over the phone
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Thank you for your support – it makes a huge difference to our patients, their families and our staff.
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