Name*
Address*
Phone*
Email*
Organization Name*
Organization EIN (Tax ID)*
Organization Cause* EducationHealthcareCommunityEnvironmentOther
Event Type* FundraiserCommunity EventSchool ProgramOther
Date/Time*
Number Attending*
Tell us why*
Please upload a letter on organizational letterhead or event flier*
If a business, please upload your 501(c)(3) IRS designation
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Are you over 21 years of age?