Organization Requesting  Fundraiser:          

 

Primary Contact:                                             

Phone Number of Contact:                             

E-Mail of Contact:                                          

Frequency of Fundraiser                                 Choose one One Time Only Yearly Semi-annually Quarterly Monthly Weekly Other

Date of Fundraiser:                                         mm/dd/yyyy

Recipient of Funds:                                        

Location of  Fundraiser:                 Onsite                    Offsite

Amount of Funds Expected to be raised:       Choose one Under $500 $500 - 1,000 $1001 - 2500 $2,500 - 5,000 $5,000 or more

Please describe fully the activity involved with this fundraiser  

Attach file with more information (note must be a Word .doc or Adobe.pdf format)