Third-Party Fundraiser Application | Norton Children's Louisville, Ky.

Name of business, group or organization

Contact person*

First Last

Home or cellphone*

Work phone

Email*

Name and description of event/fundraiser*

Fundraiser project location

Street address Address line 2 City State ZIP Code

Fundraiser start date*

Fundraiser end date*

Open to the public?*

By invitation?*

Do you plan to seek sponsorships or gifts from local corporations?*

Who will be asked to attend/support this event?

How will this event/project be promoted?

Estimated revenue goal*

List any additional beneficiaries:

Estimated donation goal*

Estimated date funds will be donated*

Direct my donation to:*

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

Please specify:

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

First Last

Other notes