| Charlie’s Fundraiser Application

Location where you will pick up your donation check.(Required)

Name of Organization(Required)

Make Check Payable to(Required)

Complete and attach (see below) a W-9 for the organization listed here. We will not accept applications without this form. The IRS requires us to collect the W-9, even if your organization is tax-exempt. Note: a 1099 form will be issued if applicable.

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Contact Name(Required)

First Last

Contact Email(Required)

Enter Email Confirm Email

All fundraiser details will be communicated to this address.

Contact Mobile Phone(Required)

Requested Fundraiser Start Date(Required)

This date must be greater than 30 days and less than 90 days from today.

Forms Submission

Organization Logo

Accepted file types: jpg, png, Max. file size: 300 MB.

A logo is not required but can be added and is suggested especially if it is recognizable by your friends and family.

Participant/Member List

Accepted file types: pdf, xlsx, Max. file size: 300 MB.

Adding your participants allows family and friends to support specific members and allows you to track and reward participation.

Terms and Conditions Acknowledgement

Terms and Conditions Acknowledgement(Required)

Please read and acknowledge the following statements.

I am an authorized signor for the above organization and enter into this agreement with their full consent.

I will submit Photo ID & Organization W-9 prior to application acceptance.

I understand Logo and Participant/Member list cannot be added unless submitted with this application.

The URL and QR code issued to us will only be available during the fundraiser dates.

Funds will be released to our organization within 30 business days after the fundraiser ends.

I will show proof of identity, acknowledge donation, and participate in a check presentation with image release.

Acknowledgement(Required)

Type full name to acknowledge and accept Terms and Conditions.