Miss Black GA USA Contestant Fundraiser Approval Form
ALL INDIVIDUAL CONTESTANT FUNDRAISERS MUST BE APPROVED THROUGH THE STATE OFFICE. Fill out the corresponding form for your division. Approvals can take up to 72 hours (3 Business Days). We further reserve the right to refuse or deny any fundraiser that does not coincide with the image we wish to associate with. ALL FEES PAID TO MISS BLACK GEORGIS USA/A.VAN DYKE PRODUCTIONS ARE NON-REFUNDABLE AND NON-TRANSFERRABLE.
Name
*
Email
*
example@example.com
Division
*
TALENTED TEEN
MISS
MS.
Title (City/County/Region-Only) Example: Atlanta
*
Name of Fundraiser/ Individual/Business/Organization
*
Type of Fundraiser. Please give a brief description of your fundraiser here.
*
How will money be collected?
*
Fundraiser Start Date
*
-
Month
-
Day
Year
Date
Fundraiser End Date
*
-
Month
-
Day
Year
Date
I understand that I am required to turn over all funds collected during any fundraiser which uses my title or is in reference to raising funds for the pageant to the State Pageant by 72 hours (3 business days) after the conclusion of the fundraiser.
*
I agree
Submit
Should be Empty: