First Name*

Last Name*

Title in Group*

Select Activities Director Administrator Advisor Band Director Board Member Chief Executive Officer Chairperson Coach/Athletic Director Co-Chairperson Development Director Director Executive Director Manager Member Owner President Principal PTA/PTO President Scout/cub Master Secretary Sponsor Teacher Treasurer Vice President Vice Principal Youth Director/Leader Other

Address 1*

Address 2

City*

State*

Select Alberta Alaska Alabama Arkansas Arizona British Columbia California Colorado Connecticut District Of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Manitoba Maryland Maine Michigan Minnesota Missouri Mississippi Montana New Brunswick North Carolina North Dakota Nebraska Newfoundland New Hampshire New Jersey New Mexico Nova Scotia Northwest Territory Nevada New York Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island South Carolina South Dakota Saskatchewan Tennessee Texas Utah Virginia Virgin Islands Vermont Washington Wisconsin West Virginia Wyoming

Zip*

Country*

Select United States Canada

E-mail Address*

Daytime Phone*

Group Name*

Group Type*

Select Schools - College/University Schools - Elementary Schools - High Schools - K-12 Schools - K-8 Schools - Middle Schools - Special Schools - Vocational/Tech Youth Community Groups Adult Community Group Corporate Employee Benefit Corporate Fund Raiser Credit Union Retail - Kiosk Retail - National Bookstore Retail - National Chain Retail - Other Other

How much do you raise annually?*

Select Currently Do Not Fundraise $0 - $500 $501 - $1,000 $1,001 - $2,000 $2,001 - $5,000 $5,001 - $7,500 $7,501 - $10,000 $10,001 - $15,000 $15,001 and more

No. of members in your group?*

How many people will be fundraising?* 

Select 0 to 5 6 to 10 11 to 25 26 to 50 51 to 100 101 to 250 251 to 500 501 and more

What is your fundraising goal?*

Select $0 - $500 $501 - $1,000 $1,001 - $2,000 $2,001 - $5,000 $5,001 - $7,500 $7,501 - $10,000 $10,001 - $15,000 $15,001 and more

When would you like to begin?*

Select January February March April May June July August September October November December

What will you do with the funds?*

Select Contribute to General Fund Funds for a Specific Need Group cause/Charity Unknown at this time

How did you hear about us?*
Select from list below Activities Resource Guide Advertising in an email newsletter Direct Mail Entertainment Book Fund-raising products website I worked with Entertainment in the past Other community group chairpeople Other leaders in school PTO Today Parent Group Info Pack Philathropic Website Search Engine Superpages www.fundraising.entertainment.com - contact us Other