Fundraiser Request Form

Organization Name*
What are you fundraising for?*
Contact Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Shipping & Purchase Distribution Notes:
- Please note: Free shipping may not be available in NWT, Yukon, and Nunavut. Tailgate delivery fees may also apply to residential addresses. We will provide more information once your Request Form has been reviewed
- Your organization will be responsible for distributing all products so we would be shipping all orders in bulk to one centralized location.
Address (where we will deliver the product to at the end of the campaign)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is the delivery location in a residential area?
Does the delivery location have a loading dock?
Campaign Start Date (if known)

MonthDayYear
Campaign End Date (if known)

MonthDayYear
Date
How did you hear about our Fundraising Program?
Anything else we should know about your request?
Should be Empty: