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	Your personal information
	First Name:	*
	Last Name:	*
	Your title:	Select one of the following Activities Director / Coordinator Assistant Coach Athletic Director / Coordinator Coach / Trainer Director / Manager District Administrator Fundraising Chairman / Committee Information Officer Leader / Captain Member / Volunteer Minister / Youth Minister PTA Parent Pastor / Youth Pastor President / Vice President Principal / Ass. Principal Secretary Teacher Treasurer Other
	Email:	*
	Group Name:	*
	Address:	*
	City:	*
	State / Province:	Select one of the following AL – Alabama AK – Alaska AZ – Arizona AR – Arkansas CA – California CO – Colorado CT – Connecticut DE – Delaware DC - District of Columbia FL – Florida GA – Georgia HI – Hawaii ID – Idaho IL – Illinois IN – Indiana IA – Iowa KS – Kansas KY – Kentucky LA – Louisiana ME – Maine MD – Maryland MA – Massachusetts MI – Michigan MN – Minnesota MS – Mississippi MO – Missouri MT – Montana NE – Nebraska NV – Nevada NH - New Hampshire NJ - New Jersey NM - New Mexico NY - New York NC - North Carolina ND - North Dakota OH – Ohio OK – Oklahoma OR – Oregon PA – Pennsylvania RI - Rhode Island SC - South Carolina SD - South Dakota TN – Tennessee TX – Texas UT – Utah VT – Vermont VA – Virginia WA – Washington WV - West Virginia WI – Wisconsin WY – Wyoming AB – Alberta BC - British Columbia MB – Manitoba NB - New Brunswick NL – Newfoundland NT - Northwest Territories NS - Nova Scotia ON – Ontario PE - Prince Edward Island QC – Quebec SK – Saskatchewan YT - Yukon Territory *
	Zip Code:	*
	Our customer service department may call to confirm you received your kit and answer any questions
	Prefered Phone:	()-* Ext. Type Select Office Home Cell Other *
	Best time to call:	Select one of the following 7 AM 8 AM 9 AM 10 AM 11 AM 12 AM 1 PM 2 PM 3 PM 4 PM 5 PM 6 PM 7 PM 8 PM 9 PM 10 PM 11 PM *
	Alternate Phone:	()- Ext. Type Select Office Home Cell Other
	Your Organization Information
	1- Your Organization?	Select one of the following Daycares/Pre-school Elementary School Middle School Middle School Booster High-school High School Booster College/University Sports team or league Church Groups Church- Youth Boy Scouts / Girl Guides Recreation Centre Charitable/Civic Company Other *
	2- Your Group?	Select one of the following Baseball Basketball Cheerleeding Class fundraiser Class Trip Entire group Football Golf La Crosse Music Others Prom Senior Group Soccer Softball Volleyball Wrestling Youth Group *
	3- # of Group Members?	*
	4- Begin Fundraiser?	Select one of the following January February March April May June July August September October November December Our fundraising is ongoing *
	5.- Fundraiser Goal?	$ *
	6- Your Role?	Select one of the following I DECIDE which fundraising option to use. Others will also participate in the decision *

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