6370 Old Washington Rd.,Elkridge, MD 21075

Fundraiser Application

Date (required):

Name of Organization :

Is your organization a 501 (c ) 3?:

Federal Tax ID #:

Contact Person:

Contact Phone:

Contact Email:

Organization Name:

Organization Website:

Organization Mailing Address:

Funds raised will support:

Treasurer/Business Manager:

Treasurer Business Manager Phone:

Treasurer Business Manager Email:

Number of tickets:

Sale Start Date:

Store location to Pick up:

Additional information:

Human error checking: