START YOUR CAMPAIGN CAPTURE YOUR DETAILS Full Name *Required* MissMrMrsDrProf.Hon. Email Address *Required* Telephone Number Please include International Code/Country Code Cell/Mobile Number *Required* Please include International Code/Country Code Address City *Required* Select Your Country *Required* AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCentral African RepublicChadChileChinaColombiaComorosCongoCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDemocratic People's Republic of Korea (North Korea)Democratic Republic of the CongDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic Republic (Laos)LatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesia (Federated States of)MonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRepublic of Korea (South Korea)Republic of MoldovaRomaniaRussian FederationRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth SudanSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyrian Arab RepublicTajikistanThailandTimor-LesteTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited Republic of TanzaniaUnited States of AmericaUruguayUzbekistanVanuatuVenezuelaVietnamYemenZambiaZimbabwe CAPTURE YOUR CAMPAIGN AND STORY CAMPAIGN HEADING (YOUR PUNCH LINE) *Required* Must not exceed 30 characters 30 FINANCIAL GOAL. (R1000.00 MINIMUM) *Required* WHICH CURRENCY WOULD YOU LIKE YOUR CAMPAIGN TO BE IN? *Required* —Please choose an option—ZAREURUSDPOUNDS CAMPAIGN DEADLINE *Required* The Campaign Deadline is the date that you wish to end your campaign. TELL US YOUR STORY (YOUR CAMPAIGN) *Required* *Minimum of 450 characters* CAPTURE YOUR IMAGES CAMPAIGN PICTURE *Required* Please upload your campaign picture below. Upload File *Required* Picture should be portrait (vertically orientated). The more campaign specific your picture is, the more you increase your chances of your Success! CAPTURE VIDEOS AND SOCIAL MEDIA LINKS YOUTUBE LINK Add a Youtube link to your Campaign (optional). Note to be additional subject to approval. SOCIAL MEDIA LINKS Add Your Campaigns Social media Links (optional). HELP US TO IMPROVE ARE YOU EXPECTING DONATIONS OUTSIDE OF SOUTH AFRICA (RSA)? *Required* NoYes HAVE YOU PUBLISHED A CAMPAIGN WITH US BEFORE? YesNoNo, but I have donated to a Click n Donate campaign before SUBSCRIBE TO OUR NEWSLETTER *Required* NoYes INFLUENCER REFERENCE *Required* Patrick Bougard TERMS AND CONDITIONS I hereby agree and accept terms and conditions . *Required* SUBMIT FORM MANUALLY Having difficulty with the online form? Click on the below link to download and complete the form, then email it to us at: manualforms@clickndonate.com. Please type NAME OF YOUR CAMPAIGN in your email's subject line. Please click here to download. To download and print HOW IT WORKS pdf, please click here To download and print WITHDRAWAL PROCESS pdf, please click here To download and print HOW DO I DRIVE MY CAMPAIGN TO SUCCESS pdf, please click here