Name*

Title Select One Fund Raising Coordinator President/Group Leader Vice President Secretary Treasurer

Group*

City*

State 

E-mail*

Home Phone*

Work Phone 

Group Size*

Web Site

Group Type

Select One Athletic/Sports Group Church - School Church - Youth Group Church - Other Day Care Elementary School Elementary School PTA/PTO Middle/Junior High School - Group Middle/Junior High School - Sports Middle/Junior High School -  Other High School - Group High School - Sports High School - Other Private School - Group Private School - Sports Private School - Other Work - Non-profit Work - Other Other

Best Time

To Call

Select One Anytime 9:00 am - noon Noon - 3:00 pm 3:00 pm - 6:00 pm 6:00 pm - 9:00 pm

Dollar Goal

Select One < $500 $500 - $999 $1,000 - $2,499 $2,500 - $4,999 $5,000 - $9,999 $10,000 - $19,999 $20,000+

Start Date 1

mm/dd/yy

Start Date 2

Crazy About Cookies E-Coupon® Little Caesar's Pizza® Fundraising Kits 

Heritage Candles®  Order Taker  Snackin' In The USA® Order Taker

Home Style Fudge® Order Taker La Boutique® Order Taker

Has your group sold a fundraiser in the past?

Yes  No

If Yes, what did you sell?