HWBC - IBEW Teams

Participation in Community Fundraising Events Related to Health and Wellness

Application for Financial Support – IBEW Teams
The mandate of the IBEW Health, Wellness and Benefits Committee is to protect and maintain the interests of the IBEW and its members with respect to health, wellness and benefits. The purpose of these funds is to provide assistance to teams of IBEW members interested in participating in community fundraising events related to health and wellness. To be considered for funding, the following criteria must be met:
- The event must be sponsored by a non-profit agency or group
- The fundraising event must be related to health and wellness
- The event must involve physical activity on the part of participants
- The majority of participants on the team must be IBEW members
- The team must represent itself as being sponsored by the IBEW
Eligible costs include registration fees, purchase of items required for participation (T-Shirts, hats, water bottles etc.) and other activities associated with participating in the event.
Part 1

Applicant Information
Primary Contact *

First Name Last Name
Phone Number *

Area Code Phone Number
Email *
example@example.com
Work Location *
Name of Group *
Part 2

Description of IBEW Teams Activity
Provide a brief description of the activity or attach relevant information. Identify the number of IBEW members who will be involved. *
Part 3

Summary of Expenses
Itemize the anticipated costs associated with this activity *
Total Estimated Expenses *
Agreement & Signature

I agree that this form is accurate to the best of my knowledge.
Please type your full name *
Signature (use computer mouse)

Clear
Date

Month Day Year
Enter the message as it's shown *
You may submit this form electronically by selecting the SUBMIT button, or you may select the PRINT FORM button to send it via:

- Email (info@ibew37.com)
- Fax (1-800-723-1226)
- Internal Mail (NB Power members)
Should be Empty:

Participation in Community Fundraising Events Related to Health and Wellness

Part 1

Part 2

Part 3

Agreement & Signature