Third Party Event Form
Interested in organizing a fundraiser for The ALS Association CT Chapter? That's great!! Thank you so much! We sincerely appreciate your time and passion to support our Chapter!

Organizing a successful fundraiser takes time, planning, and communication, but we are here for every step of the way!

Step 1- fill out this form with as much information as you can (if you need to leave a few things blank, that's totally ok!

Step 2- Jacky from the CT Chapter will reach out to you and help you every step of the way! Need to set up a website? Need some help brainstorming ideas? Need a letter for soliciting in kind donations? We're here!

Contact Info:
Jacky Rose 
(203) 874-5050
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Your Name:
Phone Number:
Your Mailing Address:
Event Title:
Tell us a little about your why:
Fundraising Goal:
Event Description (tell us a little about what you plan to do)
Do you want to start a website to collect donation, encourage fundraising, and help tell people about your event?
Clear selection
Preferred Contact Method:
Any initial questions, concerns, or ideas?
Clear form
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