Post-Event Reporting Form (Fundraising and Educational Events)
IMPORTANT: This form must be completed in detail and filed with the NCCC 14 days following the fundraising event. Complete the form below as accurately as possible.
Chapter Name (if not applicable type N/A) *
Your answer
Contact or Chapter Leader Name *
Your answer
Contact Email Address *
Your answer
Contact Phone Number:
Your answer
Event Name
Your answer
Event date
Your answer
Number of Attendees
Your answer
Fundraising Revenue and Expenses
Skip this section if the event was an educational event
Revenue
Contributions—cash
Your answer
Contributions—checks
Your answer
Contributions—online
Your answer
Ticket sales/admission fees
Your answer
Sale of advertising/vendor fees
Your answer
Sponsor fees
If you have sponsors, please enter their information at the bottom of this form. They will be sent a letter of thanks for their tax records.
Your answer
Other
Please describe
Your answer
Revenue—subtotal
Your answer
Expenses
Facility Rental or Equipment
Your answer
Printing
Your answer
Postage
Your answer
Advertising/publicity
Your answer
Materials purchased from NCCC
Your answer
Decorations/favors/prizes
Your answer
Food/drinks
Your answer
Other expenses
Please describe
Your answer
Expenses—subtotal
Your answer
Revenue Distribution
Revenue—subtotal
Enter from above
Your answer
Revenue for chapter
70% of revenue (Multiply subtotal above by 0.70)
Your answer
Expenses—subtotal
Enter from above
Your answer
Net revenue
Subtract expenses from revenue for chapter to calculate net revenue for chapter
Your answer
Please print a copy of this form and submit it with all receipts, invoices, check requests and any other documentation needed along with all funds collected to NCCC at:

ASHA/NCCC
PO Box 13827
Research Triangle Park, NC 27709

PLEASE INCLUDE SIGNATURE DELIVERY WHEN YOU SEND YOUR PACKAGE.

Sponsors and In-kind donations
If you had paid sponsors for your event or received in-kind donations, please complete the section below. If you had more than two sponsors/in-kind donation, please provide details on on additional sheet and submit that to your chapter manager via email.
Sponsor/Company name
Your answer
Contact name
Your answer
Contact email
Your answer
Address
Your answer
Donation amount—cash
Your answer
Donation value—in-kind
Your answer
Goods received in-kind
Please describe
Your answer
Total
Your answer
Sponsor/Company name
Your answer
Contact name
Your answer
Contact email
Your answer
Address
Your answer
Donation amount—cash
Your answer
Donation value—in-kind
Your answer
Goods received in-kind
Please describe
Your answer
Total
Your answer
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