FSMH TEAM FUNDRAISING PERMIT REQUEST
TEAM NAME
*
EXAMPLE: FS601
DIVISION
*
U5
U7
U9
U11
U13
U15
U18
TEAM CONTACT
*
First Name
Last Name
TEAM EMAIL
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
DESCRIBE FUNDRAISER
*
RAFFLE OR EVENT DATE:
-
Month
-
Day
Year
Date
IS AN AGLC LICENSE REQUIRED
*
YES
NO
EXPECTED INCOME:
IF A RAFFLE PLEASE PROVIDE DETAILED INFORMATION AS TO HOW FUNDS WILL BE USED FOR THE TEAM:
FACILITY NAME/DRAW LOCATION: (IF USING A FACILITY)
FACILITY ADDRESS
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Submit
Should be Empty: