Comm Fund Test Page

First Name

Last Name

Phone^*

Email^*

Business Name (if applicable)

Business Website (if applicable)

Street Address

Address Line 2

City

State / Province

ZIP / Postal Code

Is this a business or personal fundraiser^*

Business

Personal

What are your fundraising goals? Briefly explain how funds will be raised.^*

Date of the fundraiser^*

Please describe how you will be promoting your fundraiser^*

Would you like to use Closer to Home’s name or logo in your promotions ?^*

*Please note: Closer to Home will provide written approval for logo use and placements.

YES

If donating a portion of net proceeds, please specify the percentage or dollar value^*

% value

$ value

N/A

What is the expected date for funds disbursement to Closer to Home?^*

Is there anything else you’d like us to know?

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