Children's Healthcare of Atlanta

By answering the following questions, you will help us learn more about your potential fundraising event. Community fundraising events require prior sanction and approval from Children's. Submitted event applications are reviewed weekly and a Children's representative will contact you once the application has been reviewed within the week it was submitted.

Thank you for your interest in supporting our young patients.

Please provide your contact information below:


	Title:
*	First Name: Required
*	Last Name: Required
*	Email: Required
	Street 1:
	Street 2:
	City:
	State / Province:
	ZIP / Postal Code:
*	Phone Number: Required
	Yes! I want to be able to receive emails from Children's Healthcare of Atlanta Foundation staff, leaders, and programs.

Question - Not Required - Event Name

Question - Not Required - Event Location

Question - Not Required - Event Date

Month

Day

Year

Question - Not Required - Address

(Maximum response 255 chars, approx. 5 rows of text)

Question - Not Required - Description of event (3-4 sentences)

Question - Not Required - Event Website (if applicable)

Question - Not Required - Ticket/registration website (if applicable)

Question - Not Required - Service Line:

Question - Not Required - County

Question - Not Required - Estimated donation amount

Question - Not Required - Name of Children's contact (if you are in touch with one)

Question - Not Required - What, if any, support (e.g., logo, balloons, banners) will be requested from Children's?

(Maximum response 255 chars, approx. 5 rows of text)

Question - Not Required - Explain your publicity/promotion plans

(Maximum response 255 chars, approx. 5 rows of text)

Community Fundraising Event Application

Thank you for your interest in supporting our young patients.