Fundraising Application - Tully's Good Times

Fundraisers are held on Monday, Tuesday or Thursday. Fundraiser applications are approved based on fully completed applications and date availability. Requests must be submitted at minimum 2 weeks prior to requested date.

Requested Information
Name of Organization*
The name reflected on fundraising materials (your fundraiser coupons)
Check Made Payable To*
The name reflected on check at the completion of your fundraiser
Address*
(where you would like the check mailed to)
Street Address Address Line 2 City State ZIP Code
Organization's Tax ID number
Contact Person's Name*
Contact Person's Phone Number*
Contact Person's Email*
Select a Preferred Date*
Must be a Monday, Tuesday, or Thursday
Month
Day
Year
Select a Second Date*
In the event that your first choice is not available
Month
Day
Year
Estimated number of people to attend*
Choose a Location*
Is your organization a qualified 501 (C)3 organization?*
- Yes
- No
Sign your name to confirm
Since you answered "yes" to the above question, please read and sign this notice:
In order to conform with Internal Revenue Code Section 170(f)(8), our organization states that it did not provide goods and services in consideration for this gift. (To sign- please type your name)
How did you hear about our fundraising opportunities?
Additional comments and questions
Authorization
I understand that by signing below, I am authorizing someone to contact me in regards to Fund Raising opportunities with Tully’s Good Times. I also understand that by returning this form, Tully’s Good Times is under no obligation to hold the Fund Raiser. If we agree to schedule the Fund Raiser, the organization that I represent will not hand out Fund Raiser Coupons on the premises or in the parking lot at any time. Doing so may result in cancellation of the event. I give permission to Tully’s Good Times to use my organization’s name and donation amount from the above event in response to media inquires. (To sign- please type your name and date) *
Signature Name*
Signature Date*
Month
Day
Year

Requested Information

Authorization

Come be part of the team!