Sponsorship Request Contact Person's Name (required) Contact details (phone & email) Location of project Organisation name Registration Number PBO number Beneficiary Demographics: Race 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? Please tell us about your corporate/organisational governance Other information not included above you consider important to support favourable consideration of your request Your Email (required)