Champions for Kids Fundraiser Application | Norton Children's Louisville, Ky.

Name of organization

Contact person*

First Last

Home or cell phone*

Work phone

Email*

Name and description of event/project*

Fundraiser project location

Street Address Address Line 2 City State ZIP Code

Fundraiser Project Date(s) and time

By invitation?*

Estimated revenue goal*

Open to the public?*

How will this event/project be promoted?

Please list any beneficiaries*

Estimated donation goal*

Estimated date funds will be donated*

What resources do you need from the Children's Hospital Foundation?

If you selected "Other" above, please specify

Do you plan to seek gifts from local corporations?*

Who will be asked to attend/support this event?*

Please specify if you have an area of interest within the hospital*

If you selected "Other" above, please specify

Have you spoken to a staff member at the Children's Hospital Foundation?

First Last

Other notes