Request for Activity and/or Fundraising Event

All event/fundraising requests must be completed two(2) weeks prior to event.

Organization Name:  
Activity/Event Date(s):  
Time of Activity/Event:  
Description of Activity/Events:
(Be specific.)
Purpose of Activity/Event:
Intended Use of Funds:
Projected Cost:
Projected Gross Income:
Submitted By:
  By submitting this form, I hereby affirm that the above information is true and my organization/department will be bound by the conditions herein.