Upload
vodang
View
215
Download
0
Embed Size (px)
Citation preview
Note: This application must be approved by The Children’s Hospital of Buffalo Foundation prior to publicizing or holding an event
EVENT PROPOSAL FORM
1) Name of Group/Company Planning Event: Date:Name of individual responsible:Mailing Address:City: State: Zip Code: Home Tel: ( ) Business Tel: ( ) Fax: ( ) E-mail:
2) Name of proposed Event:Date: Time: Location of Event: Location Phone#:Address: City:
3) Brieflydescribetheeventandhowthefundswillberaised.Pleaselistthenamesandaddressesofyourvolunteers:Use back side if needed:
Please restrict funds to:
4) Proposed Budget: All costs to come out of proceeds or to be paid directly by event organizer. Please list all costs even if you expectthem to be donated.
COSTSLocation ......................................................................................................................................................$ Food/Beverage ............................................................................................................................................$ Printing (tickets, posters, etc.).......................................................................................................................$ Advertising ..................................................................................................................................................$ Prizes .........................................................................................................................................................$ Other(please specify) ...................................................................................................................................$ TOTAL COSTS: ...........................................................................................................................................$ Total Expected Income ................................................................................................................................$ (-) Total Costs ............................................................................................................................................$
(=) Revenue to $
5) Does your event require a license? Yes No
6) PleaseattachacopyofInsuranceCertificateifapplicable.
7) PleasebeadvisedthatbypubliclynamingThe Children’sHospitalofBuffaloFoundationasthebeneficiaryof yourinitiative,youare requiredtodonate100%ofthenetrevenuesraisedonourbehalf.BysigningbelowyouagreeThe Children’s Hospital of Buffalo Foundationwillreceiveallnet revenuesfromtheeventwithin30 days of the event.
8) Bysigningbelow,youagreethatallpublicityfortheproposedeventmust be approved by The Children’s Hospital of Buffalo Foundation prior to being printed, released, etc. Logo examples are provided on the next page.
SIGNATURE OF APPLICANT: DATE:
Please return the completed and signed form to: The Children’s Hospital of Buffalo Foundation, 1028 Main St., Fl 4 Buffalo, NY 14202. Questions? Please call 881-8230
Acknowledgmentofyourapplicationwillbeforwardedtoyouwithin10businessdays.Your support is greatly appreciated.
For Foundation Use Only: Approved By: Date Approved: Record #:
John R. Oishei Children’s Hospital
___