Fundraiser Application Form

Apply for Our Fundraising Program

"*" indicates required fields

Name of Group/Organization*

As should be stated on Order Forms

Group Coordinator*

Phone

Address*

Street Address Address Line 2 City State ZIP Code

START DATE:

END DATE

Expected PRODUCT PICKUP/SHIP DATE:

Number of Sellers:

Who would you like checks made payable to?

Which sizes would you like to sell?

Pint Jar - $17/each (earn $8.50/candle)

Half Pint - $10/each (earn $5.00/candle)

Country Sampler - $7/each (earn $3.50/candle)

Qubes - 3/$15 each (earn $5/per pack)

Are you interested in purchasing sample display kit(s) at discount rate? (If yes, we will contact you for details).

Yes

Please explain briefly how your proceeds will be used:*

Email Address*