3rd Party Event Participation Form

URL

This field is for validation purposes and should be left unchanged.

First Name*

Last Name*

Address 1*

Address 2*

City*

State*

Zip / Post Code*

Email*

Daytime Phone*

Fax

Hosting Group Name (if applicable)

Hosting Group Twitter Handle

Hosting Group Facebook Page

Are you a*

Is this event*

Date of Event*

Event Begins

Event Ends*

Event Information Phone

Event Information Email

Event Website

Where are you hosting your event?*

Please describe your event, be as thorough as possible.*

Will you have a ticket price or entrance fee?*

If yes, please include price information.

If hosting an in-kind fundraiser, what items do you plan to collect?

Diapers, toiletries, cell phones, etc.

How will this event benefit SAFE?

Example: 10% of ticket sales will be donated to SAFE.

Will there be entertainment? Please be as specific as possible.*

Please list other organizations that will also benefit from this event.

Will businesses be contacted for donation for your event?*

If yes, please list prospects for us to review to avoid duplicated efforts with businesses we may have already approached.

Do you wish to use SAFE's name, logo or program/service information to help promote your event?*

If yes, what types of promotion do you plan to use?

Please check all that apply.

Would you like a link sent containing various materials to print?*

I have read, understand and agree to the guidelines posted for hosting a fundraiser to benefit SAFE.*

Please type name in lieu of signature.

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