EmailMe Form - 5% Day Application

5% Day Application

Organization Name *

Organization Address *

Street Address *

Address Line 2

City *

State / Province / Region *

Postal / Zip Code *

Country *

Contact Name *

Prefix

First *

Last *

Suffix

Contact Title *

Phone Number *

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Email *

Please briefly outline the history of your organization: *

Is there a specific project for which the 5% Day contribution will be used? *

How many members does your organization have? *

How would you publicize the event to your members and to the public? *

Tell us about other fundraising events your organization has held. Which were the most successful? *

From what other sources fo you recieve major funding? *

We encourage the benefiting organization to be visible in the store prior to and on the day of the event. How would you take advantage of this opportunity? How many member or staff will be available during business hours to participate? *

Is there a time of year when your organization would best support a 5% Day? *

Is ther a time of year when your organization would not be able to adequately support a 5% Day? *

We require a brief evaluation of the program for which the funds are contributed. How long after the 5% Day could we expect your report? *

Names of your organization's key officers or Board Members: *

Application prepared/submitted by: *

Date *

YYYY

Please attach a copy of the organization's 501(c)(3). *

Additional information:

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