Contact Person & Organization:
Prefix* :
- Select One -
Dr.
Mr.
Miss
Ms.
Mrs.
First Name* :
Last Name* :
Organization/Group Name* :
Your Position in Your Organization/Group* :
Organization's Civic Address:
Street Number* :
Street Name* :
Apt./Suite #:
City/Town* :
Province/State* :
[Select Province/State]
[Canada]
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
United States
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Postal/Zip Code* :
Country* :
[Select Country]
Canada
United States
Organization's Mailing Address: (If Different than Civic Address)
P.O. Box:
Street Number:
Street Name:
Apt./Suite #:
City/Town:
Province/State:
[Select Province/State]
[Canada]
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
United States
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Postal/Zip Code:
Country:
[Select Country]
Canada
United States
Internet Address:
Contact Person's Email Address* :
Organization's/Group's Email Address: (If different than Contact Person's Email Address)
Organization's/Group's Website:
Contact Numbers:
Contact Person's Telephone Number* :
( )
-
Ext.
Contact Person's Cell Number:
( )
-
Organization's/Group's Telephone Number* :
( )
-
Times Available:
Preferred Time to Call:
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Any Time (9am-9pm)
Business Hours (9am-5pm)
Morning (9am-12pm)
Afternoon (12pm-5pm)
Evening (5pm-9pm)
Preferred Day to Call:
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Any Day
Any Weekday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Your Time Zone:
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Atlantic Standard Time
Central Standard Time
Eastern Standard Time
Mountain Standard Time
Pacific Standard Time
Newfoundland Standard Time
Yukon Standard Time
Alaskan Standard Time
Hawaii-Aleutian Standard Time
Type of Organization/Group:
What best describes your Organization/Group* :
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Elementary School
Middle School / Junior High
High School
School - Grades 7 to 12
School Class or Specific Grade
School Choir
School Trip Committee
Private School
University / Community College
Church Congregation
Church Choir
Youth Church Group
Seniors Church Group
Youth Sports Team
Senior Sports Team
Sporting Association
Youth Dance Group / School
Senior Dance Group / School
Youth Choir
Senior Choir
Youth Band / Orchestra
Senior Band / Orchestra
Youth Theatre Group
Senior Theatre Group
Artists / Photographers
Boy Scouts / Girl Guides
Cadets / Military
Legion / Lodge
Organized Club
Special Interest Society
Non-Profit Group
Registered Charity
Professional Association
Organized Event Committee
Festival Committee
Parks & Recreation
Resource Centre
Crisis / Support Service or Facility
Food Bank
Community Shelter
Counseling Service
Daycare Centre
Youth Care Facility
Special Care Home
Seniors Long Term Care Facility
Hospital / Health Care
Research & Development
Animal / Pet Care Facility
Neighborhood Benefit
Corporation
Retail
Individual / Family
Other Organization/Group
Other Organization/Group, please specify:
Organization/Group Size* :
How many members are in your Organization/Group* :
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1
2-5
6-10
11-15
16-20
21-25
26-35
36-50
51-75
76-100
101-150
151-200
201-250
251-300
301-350
351-400
401-450
451-500
Over 500
(Please Note: Depending on your type of Organization/Group, Remember to count the total Number of: Teachers and Students in your School, or People in your Church Congregation, or Coaches and Players on your Team, or Musicians (Including the Conductor) in your Band, or Executive and General Members in your Club, Group or Organization)
Age Group:
What is the average age group of the members in your Organization/Group?*
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Under 12Yrs
12Yrs - 18 Yrs
19Yrs - 25Yrs
26Yrs - 34Yrs
35Yrs – 49Yrs
50Yrs - 64Yrs
65 Plus
Mix of All Ages
Fundraising Schedule:
When would your Organization/Group like to hold a Fundraiser?*
Fundraising Goal:
How much money would your Organization/Group like to raise with Johnny's 2 for 1 Coupon Book?*
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Less than $1000
$1000 - $2000
$2001 - $4000
$4001 - $6000
$6001 - $8000
$8001 - $10,000
$10,001 - $12,000
Over $12,000
Organization/Group Fundraising History:
How often does your Organization/Group conduct a Fundraiser?*
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We have not held a Fundraiser Yet
Once per Year
Twice per Year
Every Three Months
Monthly
We are always Fundraising
Personal Fundraising Experience:
How many Fundraisers have you personally been involved in?*
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I have not participated in a Fundraiser yet
I have only participated in 1 Fundraiser in the past
I have participated in 2 or 3 Fundraisers in the past
I have participated in 4 to 6 Fundraisers in the past
I have participated in Many Fundraisers over the years
I am constantly participating in various Fundraisers
(Please include All Organizations, Past and Present)
Fundraising Accomplishments:
What was the most successful Fundraiser to date, that you have personally been involved in? (Please tell us the name of the Organization/Group and describe the Product that was sold, the Service that was provided or the event that was held. If you have not participated in a Fundraiser yet just enter "No Experience")
How many people participated in that Fundraiser?
- Select One -
I have not participated in a Fundraiser yet
1
2-5
6-10
11-15
16-20
21-25
26-35
36-50
51-75
76-100
101-150
151-200
201-250
251-300
301-350
351-400
401-450
451-500
Over 500
Approximately, how much money was raised from that Fundraiser?
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I have not participated in a Fundraiser yet
Less than $1000
$1000 - $2000
$2001 - $4000
$4001 - $6000
$6001 - $8000
$8001 - $10,000
$10,001 - $12,000
Over $12,000
Message* :
Enter your Fundraising Inquiries Here. Also, please tell us a little about your Organization/Group and why you are conducting a Fundraiser.