Event / Fundraiser Evaluation Form

Please fill out our event / fundraiser form below. We require organizers to register their event / fundraiser to ensure that we provide the appropriate support and to assist in the promotion of the event within the community.

Note: Applications must be approved by the Learning Library Campaign prior to publicizing or holding events / fundraisers. Use of the campaign name or logo must also be approved prior to use.

Organizers, please be advised that by publicly designating The Learning Library as the beneficiary of your efforts, you are required to donate the full amount of funds raised on our behalf. You agree that proceeds will be turned over to the campaign within 60 days of the completion of your event / fundraiser. If for legitimate reasons this time limit cannot be met, mutually agreed upon arrangements can be made.

Applications will be reviewed within 10 business days.

* Fields marked with an asterisk are required

Contact Information

Title *:	Mr. Ms. Mrs. Dr. Miss Mr. & Mrs.
First Name *:
Last Name *:
E-mail *:
Company/Group:
Mailing Address *:
Address Type:	Home Business
City*:
Province *:	Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon
Postal Code*:
Telephone:	Example: 705-123-4567x1234
Telephone Type:	Home Business

Event / Fundraiser Information

Name of Event / Fundraiser*:
Start Date*:
End Date*:
Event / Fundraiser Description*: Briefly describe the event and how the funds will be raised.

Event Publication on the Learning Library Web Site

Please provide contact information and a brief description and/or E-file materials for your event/fundraiser. Remember to include all pertinent details.

Event Organizer *:
Event Phone:	Example: 1-800-813-6166
Event Website: http://
Event E-mail:
Publication Description:

Anticipated Revenue

Please note that we realize this figure is an estimate. Please use your best guess; we will not hold you to this number.

Revenue to The Learning Library

$

Additional Information

Comments for the Campaign Committee:

References

The following two references may be contacted as part of the event / fundraiser evaluation process.

REFERENCE 1
First & Last Name*:
Telephone*:	Example: 705-123-4567x1234
E-mail:
REFERENCE 2
First & Last Name*:
Telephone*:	Example: 705-123-4567x1234
E-mail: