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.
* Required
Chapter Name (if not applicable type N/A)
*
This is a required question
Contact or Chapter Leader Name
*
This is a required question
Contact Email Address
*
Must be a valid email address
This is a required question
Contact Phone Number:
This is a required question
Event Name
This is a required question
Event date
This is a required question
Number of Attendees
This is a required question
Fundraising Revenue and Expenses
Skip this section if the event was an educational event
Revenue
Contributions—cash
This is a required question
Contributions—checks
This is a required question
Contributions—online
This is a required question
Ticket sales/admission fees
This is a required question
Sale of advertising/vendor fees
This is a required question
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.
This is a required question
Other
Please describe
This is a required question
Revenue—subtotal
This is a required question
Expenses
Facility Rental or Equipment
This is a required question
Printing
This is a required question
Postage
This is a required question
Advertising/publicity
This is a required question
Materials purchased from NCCC
This is a required question
Decorations/favors/prizes
This is a required question
Food/drinks
This is a required question
Other expenses
Please describe
This is a required question
Expenses—subtotal
This is a required question
Revenue Distribution
Revenue—subtotal
Enter from above
This is a required question
Revenue for chapter
70% of revenue (Multiply subtotal above by 0.70)
This is a required question
Expenses—subtotal
Enter from above
This is a required question
Net revenue
Subtract expenses from revenue for chapter to calculate net revenue for chapter
This is a required question
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
This is a required question
Contact name
This is a required question
Contact email
This is a required question
Address
This is a required question
Donation amount—cash
This is a required question
Donation value—in-kind
This is a required question
Goods received in-kind
Please describe
This is a required question
Total
This is a required question
Sponsor/Company name
This is a required question
Contact name
This is a required question
Contact email
This is a required question
Address
This is a required question
Donation amount—cash
This is a required question
Donation value—in-kind
This is a required question
Goods received in-kind
Please describe
This is a required question
Total
This is a required question
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