Complete the form below to sign up for the £1,000 Challenge Please sign me up for the £1,000 Challenge and send me everything I need including details about the event, fundraising tips and advice, and any useful updates about the £1,000 Challenge by email, mobile messaging and social media. Title * - Select -MrMrsMsMissMxDrProfessor First name * Last name * Date of birth * Year1920192119221923192419251926192719281929193019311932193319341935193619371938193919401941194219431944194519461947194819491950195119521953195419551956195719581959196019611962196319641965196619671968196919701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010201120122013201420152016201720182019202020212022 Year MonthJanFebMarAprMayJunJulAugSepOctNovDec Month Day12345678910111213141516171819202122232425262728293031 Day Address line 1 * Address line 2 Address line 3 Town * County Postcode * Phone number * Email * We’d love to hear more about your fundraising ideas, and whether you have any event dates booked in, so we can support you in the best way possible. Please share your ideas and plans below How did you hear about the £1,000 Challenge? * - Select -Event Organiser's WebsiteEmail from Breast Cancer NowBreast Cancer Now websiteI saw you on FacebookI saw you on TwitterI heard about you from a friendI read about you in a magazineOtherDo you have a connection to breast cancer? If you select information about your health from the drop-down menu, we may use this to provide you with tailored breast health information, volunteering opportunities and to manage how we communicate with you. We may also use this information to better understand our supporters. By selecting the information relating to my health status, I agree to Breast Cancer Now using the information for the above purpose. Do you have a connection to breast cancer? - None -I have/have had primary breast cancerI have secondary breast cancer (spread to another part of my body/metastatic)I’m worried I’m at risk of breast cancerA family member has/has had breast cancerA close friend has/has had breast cancerSomeone I know has/had breast cancerI have lost someone to breast cancerI’m a healthcare professionalI have a professional/academic interest in breast cancerI have no experience of breast cancerI’d prefer not to sayKeeping in touch with Breast Cancer Now We'd like to tell you ways you can help further, including through donating, fundraising, campaigning and volunteering and send you updates on our research, the support we provide, breast health information, and our wider work to achieve our aims. If you already hear from us, we will continue to contact you in the same way. If you don't already hear from us, please tick the box if you are happy to be contacted by: Email Mobile messaging Keeping in touch How we use your information From time to time, we may contact you by telephone and post to keep you updated on our work and ways you can help. You can change the way you hear from us at any time by emailing us at supporterengagement@breastcancernow.org or calling us on 0333 20 70 300. To help us to work more efficiently, we may analyse your information to make sure you receive the most relevant communications, and to target our digital advertising. This may include using publicly available information. You can ask us to stop this at any time, by contacting us using the above contact details. You can read more about how we will use your information in our privacy policy. Submit
