Today's Date
-
Month
-
Day
Year
Date
Full Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Campus association?
*
Beebe
Searcy
Heber Springs
Little Rock Air Force Base
What is your role with the organization or program you are applying on behalf of?:
*
Faculty / Staff
Club Advisor
Student
Other
I am applying on behalf of:
*
Student Club or Organization
College Department
Other
Organization, team, club or department name:
*
Advisor or Coaches name:
*
Start date of fundraising, activity or event?:
-
Month
-
Day
Year
Date
End date of fundraising, activity or event?:
-
Month
-
Day
Year
Date
What group or organization will this fundraising activity support?
Description of the fundraising activity or event:
*
Do you need design services?: (flyers, social media, tickets, etc)
YES
NO
What is the deadline for services?:
-
Month
-
Day
Year
Date
Will you be selling something? Please list:
YES
NO
Cost of items/tickets being sold:
*
Will you or your group be utilizing crowdfunding?: (for example: Go Fund Me)
YES
NO
Will you or your group be soliciting businesses for donations?: (for example: a gift card from Lowes)
YES
NO
List of prospective donors (individuals, businesses, corporations, foundations) who may be interested in supporting this initiative.
Does this initiative require space renovations or a new facility?:
YES
NO
If so, present a detailed budget estimate and include with this request.
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