Plan a Fundraiser

By answering the following questions, you will help us learn more about your event. When you have finished filling out the form, you will have completed the application process. Please note that the application is comprehensive and may take some time to complete.

* Required

Question - Not Required - Date submitted

Month

Day

Year

*2.

Question - Required - Please mark one: Event
Promotion
Both

Question - Not Required - Name of Organization or Individual:

*4.

Question - Required - Contact Name and Title:

*5.

Question - Required - Address 1

*6.

Question - Required - City, State

*7.

Question - Required - Zip

*8.

Question - Required - Contact E-Mail Address

*9.

Question - Required - Contact Phone Number:

10.

Question - Not Required - Name/Description of Event (If you are doing a promotion, please skip to question #27).

11.

Question - Not Required - Event Date:

Month

Day

Year

12.

Question - Not Required - Event Time:

13.

Question - Not Required - Event Location:

14.

Question - Not Required - Ticket Price

15.

Question - Not Required - On Sale Date:

Month

Day

Year

16.

Question - Not Required - Is this event: By Invitation Only
Open to the Public

17.

Question - Not Required - Has this event taken place before?

18.

Question - Not Required - If yes, when?

19.

Question - Not Required - Are there other beneficiaries besides The Children's Hospital of Philadelphia?

20.

Question - Not Required - If yes, please explain:

21.

Question - Not Required - Estimated Gross Revenue:

22.

Question - Not Required - Estimated Total Cost:

23.

Question - Not Required - Estimated Net Income:

24.

Question - Not Required - Value of goods and services received by each donor?

25.

Question - Not Required - Estimated amount to be given to The Children's Hospital of Philadelphia ($ or %):

26.

Question - Not Required - To be completed if a corporation is providing financial support or assistance. Please list the Company/Organization Name and a Contact Name.

27.

Question - Not Required - Promotion Description:

28.

Question - Not Required - Dates of the promotion:

29.

Question - Not Required - What percentage or amount does the Hospital receive?

30.

Question - Not Required - Estimated Income:

31.

Question - Not Required - Has this promotion been done before?

32.

Question - Not Required - If yes, when?

33.

Question - Not Required - How many stores are using this promotion?

34.

Question - Not Required - Please lists the stores (address and phone number):

35.

Question - Not Required - The Children's Hospital of Philadelphia will need to review all materials that include the name of the Hospital. When mentioning the Hospital's name in print or on air, please use - The Children's Hospital of Philadelphia. Please explain your publicity/promotion plans. Will they include press releases, flyers, radio/TV, printed ads?

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Plan a Fundraiser

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