Application Community Fundraiser

Community Fundraiser Registration

Thank you for choosing to support the Cancer Resource Center of Western Maine. Because we want your efforts to be successful, it is important for us to be aware of community fundraisers that are benefiting the Cancer Resource Center of Western Maine. We will support you in your promotion efforts through our website and social media, and can also provide helpful tips to maximize your fundraising efforts. Please do note that because of staffing limitations, we do not have the capacity to plan or organize your event. Thank you for understanding.

Please review our Community Fundraising Guidelines document prior to completing this registration form. (see below)
Please submit this application at least 45 days in advance of your event or promotion.

Applicant Information

* Indicates required field

Name *

First

Last

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Community Fundraiser Information

Name of the Individual/Team/Company/Organization Hosting the Event *

Event Name *

Event Description (as it would appear on the Cancer Resource Center Website *

Event Location (address or website) *

Start Date: *

End Date: *

Start Time: *

End Time: *

Will you be soliciting cash or in-kind donations from a business for the event? Yes or No *

If yes, please list items and donors *

Proposed Budget

While we understand you may not know how much money your Community Fundraiser will raise, we include a proposed budget to help you plan for expenses pertaining to venue, fee, promotion, materials, etc. We hope this will help you accurately plan and manage expectations for a successful event.

A. Total expected income (donations, ticket sales, etc.) *

B. Expenses (costs such as advertising, rentals, food, etc. *

C. Anticipated net proceeds (A minus B = C) *

D. Please indicate (in percentage or specific dollar amount) if only a portion will be donated to the Cancer Resource Center. *

Waiver

I acknowledge, by signing my name below, that I have read and understand the Community Fundraising Guidelines (see below). I also understand that the Cancer Resource Center of Western Maine and their affiliates take no responsibility for the activities conducted by a Community Fundraiser benefiting the Cancer Resource Center of Western Maine.

Signature: *

Date: *

Thank you for ensuring no one is alone in their cancer journey. We wish you the best of luck in your efforts!
As soon as we are able, we will contact you regarding your Community Fundraiser registration.

Submit

Community Fundraising Guidelines

Questions? Contact Mary Dempsey, Executive Director at mdempsey@crcofwm.org or at 207-890-0329

For printed version of form click here.

Because No One Should Face Cancer Alone

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Hours

Tuesday:
3:00 pm to 7:00 pm
Thursday & Friday: 9:00 am - 3:00 pm

Telephone

207-890-0329

Email

info@crcofwm.org