Community Partner Fundraising Proposal "*" indicates required fields Before submitting your proposal, review our Community Partner Fundraising Guidelines. Name* First Last Is this your first fundraiser?* Yes No Fundraising Goal ($)*Fund Designee*Specify the fund designee or area of care supported through you fundraisingPhone*Email* Name of your Company or OrganizationPhysical Address of Fundraiser Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Start Date of Proposed Fundraiser* MM slash DD slash YYYY End Date of Proposed Fundraiser* MM slash DD slash YYYY Basic Description of Fundraising Activity*I acknowledge that I have read all of the Terms & Conditions as outlined by Atrium Health Foundation. The person submitting this online form represents and warrants that they have the authority to submit this Community Fundraising Proposal on behalf of the event organizer.* I acknowledge that I have read all of the Terms & Conditions as outlined by Atrium Health Foundation. The person submitting this online form represents and warrants that they have the authority to submit this Community Fundraising Proposal on behalf of the event organizer. To learn more about what you can expect from our team, read our Terms & Conditions here. Please check any areas of interest and a designated member of our staff will reach out to you for more information: Promotional support via approved Atrium Health Foundation social media accounts and website event calendar Atrium Health Foundation logo in screen and print-resolution (please specify file type, if known) Vendor recommendations Access to and assistance with personal fundraising pages or editing and existing fundraising page Use of branded "giveaways" (contingent upon supplies available) An official, signed letter of endorsement printed on Atrium Health Foundation letterhead to authenticate your fundraiser Tax receipts for cash donations or checks (made payable to Atrium Health Foundation) of $50 or greater* General background information on beneficiary** Please state any other needs below:Are you currently working with an Atrium Health Foundation staff member?* Yes No Please provide the staff member's name:*Receipts will only be provided if complete donor contact information is collected and given to Atrium Health Foundation in a timely fashion. For online gifts, automatic email receipts are provided for all donations made via Atrium Health Foundation’s website and affiliated personal fundraising platform. Whenever possible, charitable proceeds from community fundraising events should be issued to Atrium Health Foundation in the form of a single check (made payable to Atrium Health Foundation). **If known and available, background information may be provided to you about the Atrium Health facility, program, or patient population benefiting from your fundraising event or activity.CAPTCHA
