Partner Interest Form

Please tell us about your Organization:

• Name of Organization:
  A value is required.
• Type of Organization:
  A value is required.
• What is the main goal of the organization?
  
• Has the organization previously held fundraisers?
  Please make a selection.
  Yes
  No
• If so, What methods of fundraising have been used?
  
• How often does the organization hold fundraisers?
  Please make a selection.
  Once a Year
  Once Every 6 Months
  Once Every 3 Months
  Once Every 2 Months
  Once A Month

Please tell us how to contact you:

• Contact Person:
  A value is required.
• Contact Phone Number:
  A phone number is required.Invalid Number.
• Best time to contact:
  Please make a selection.
  Morning
  Mid-Day
  Afternoon
  Evening
• Contact Email:
  A value is required.Invalid format.
• How would you like to be contacted?
  Please make a selection.
  Phone
  E-Mail

Address of the Organization:

• Street Address:
  A value is required.
  
• City:
  A value is required.
• State:
  Select One Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Please select a State.Please select a State.
• Zip Code:
  A Zip Code is required.Invalid Zip Code format.