Community Event Fundraising: Siteman Cancer Center

Community Event Fundraising

Event Submission Form

*Host/Group/Company planning this event

Are you representing a nonprofit organization/501(c)3?

Yes
No

Name of organization

Tax ID number

Event Organizer Information

*First Name

*Last Name

*Address Line1

Address Line2

*City

*State / Province

*Zip / Postal Code

*Country / Area

*Email

*Phone

Event Information

*Event Name

*Date (mm/dd/yy)

*Time

*Location

*Address

*Zip / Postal Code

*State / Province

Event Website

Facebook Page

Instagram/Twitter Handle

*This event is:

By invitation only
Open to the public

*Event Type

*Describe proposed event purpose and target audience.

Proposed event promotion and publicity (Please submit a copy of any proposed event materials prior to printing and distribution)

*Are there other beneficiaries besides Siteman Cancer Center?

Yes
No

*Revenue-generating activities

*Fundraising Goal

*Estimated gift to Siteman Cancer Center

*Anticipated date of check submission (must be within eight (8) weeks of the event)

My gift will be matched by my company/organization

Yes
No

Company Name

Program/Fund you would like to support with your gift

Anything else you would like us to know about your event?

Please complete and return this form six (6) months before your proposed event or initiative. Only complete forms will be taken under consideration. Until a confirmation is received, contributions should not be solicited and the name Siteman Cancer Center should not be used for any purpose. Siteman Cancer Center may withdraw approval at any time should we discover inappropriate messaging or behavior associated with the event. The event host will be notified of the approval withdrawal in writing. After approval is withdrawn, all references to Siteman Cancer Center, and related departments and programs must be eliminated. If you have any questions, please contact Brandy Meyer at mbrandy@wustl.edu or (314) 935-2993.