Fundraising Program Application
2019-2020 EMRLD 20 Fundraising Application
ORGANIZATION NAME *
CONTACT NAME (FIRST, LAST) *
ORGANIZATION ADDRESS *
CITY *
STATE *
ZIP *
PHONE # (WITH AREA CODE) *
SHIPPING ADDRESS *
CITY *
STATE *
ZIP *
TARGET START DATE *
MM
/
DD
/
YYYY
TARGET END DATE *
MM
/
DD
/
YYYY
GROUP SIZE *
# OF BROCHURES NEEDED (we will include extra) *
TARGET GOAL $ *
Briefly describe what the funds will be used for (optional):
NONPROFIT
We are required to confirm your tax exempt status, and can extend these program advantages only to organizations that meet the educational, medical, cultural, and humanitarian goals of nonprofit agency.
NAME OF NONPROFIT ORGANIZATION
TAX-EXEMPT NUMBER
Sales Tax
If applicable in your state, check the box below and email over any documentation on your tax-exempt status.
I certify that the purchase from EMRLD 20 Fundraising, by the above-named organization, is exempt from sales tax. *
Required
CONTACT PERSON (FIRST, LAST)
PHONE # (WITH AREA CODE)
ADDRESS
CITY
STATE
ZIP
Submit
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