Group Leader - First and Last Name*
Organization*
Organization Address line 1*
Organization Address line 2
City*	State*  ZIP*  Continental United States only
Group Leader E-mail Address*
Daytime Phone Number*	- -
Evening Phone Number*	- -
How many participants will be selling?*
When are you planning on having your fundraiser?	Starting Date*: Ending Date*:
Will there be any other fundraising programs conducted during this sales period?* No Yes
Special Comments or Instructions - Please note if you would like to submit artwork for a private label.
* denotes required information