Ice Bucket Challenge Progress

 

Event Request Form

Please complete the Event Request Form. A Third Party Event is any fundraising activity conducted where The ALS Association has no fiduciary responsibilities and little or no staff involvement. The ALS Association requires that all third party organizers submit a completed Event Request Form before initiating any activity.
Once the request is approved we will contact you. A Third Party Agreement will clearly define roles and expectations to help ensure a satisfying experience.
Thank you.

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  Contact Information:

If you have previously registered, please to prepopulate your information.

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Name:

 

 

 

     

 

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City/State/ZIP:

 

    

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If you respond and have not already registered, you will receive periodic updates and communications from The ALS Association Florida Chapter.

 

What's this?

Please enter a user name and password for logging in when you return. You can use this password to update your information or receive personalized content.

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5 to 60 characters

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5 to 20 characters

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  Event Information:
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Question - Required - Proposed Date of Event:




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(Maximum response 255 chars, approx. 5 rows of text)

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Question - Required - This event is


   


   


   


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(Maximum response 255 chars, approx. 5 rows of text)

 
Question - Not Required - How will the event be publicized?

 
Question - Not Required - Please check all the items/support you will require from The ALS Association Florida Chapter.

 

  Budget/Fundraising Information:
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  Please note that selecting this option will create additional requirements in order for The ALS Association Florida Chapter to approve and participate in this event.
   


 


   Please leave this field empty