PERSON REFERRING
First Name
Last Name
Group you are associated with
Where should we send your referral check to?
Address:
City
State/Province



Zip/Postal Code
Who should we make out the check to?
Your Contact Number

(h)




(o)
Your Email Address:
GROUP OR ORGANIZATION YOU ARE REFERRING
Name of Group:
Contact Person:
Address:
City:
State/Province



Zip/Postal Code
Their Email:
When would this group likely run a fundraising program?
Please provide any additional information about this group that would help us to better serve them and help with their fundraising needs?
Size of Group
Type of group (students, athletes, etc..)
Money they need to raise
Kinds of fundraisers they prefer
Fundraisers they've done in the past
Other information or comments: