Medically Related Donation Acceptance Form

Medically Related Donation Acceptance Form

In order to formally accept your award, please complete the following information:
Organisation Details

Reference number can be found on your award letter
Bank Details
Payment will be made by electronic transfer direct to bank once the Award Terms & Conditions have been met. Recipients are requested to provide the following details for the account to be credited:

Please enter numbers only, without hyphens.

Consent Statements

As we assess your application and manage your award we may need to ask some questions, so we need you to tick these boxes to say that you consent to us contacting you as set out in our Privacy Policy by:

Please note - You may withdraw your consent at any time by contacting the Trust.



The Sir Jules Thorn Charitable Trust is a Charity registered in England and Wales, number 233838


Our registered address is 24 Manchester Square, London, W1U 3TH

We can be contacted by:


Telephone on 0207 487 5851,

E-mail at,

Or through our website at