Application must be completed at least two weeks before your event.
Title of the Event
Individual, Organization or Business hosting Event
Event Coordinator's First Name
Event Coordinator's Last Name
Street
City
State
Please select...
AL
AK
AZ
AR
CA
CO
CT
DC
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip
Email
Website
Phone
Event Date
Event Time
Location
Briefly describe the event
How will the revenues be generated
Is Mobile Loaves & Fishes the sole beneficiary of your event? If not, who else is benefitting?
What participation or resources, if any, do you request from Mobile Loaves & Fishes
Anticipated total donations to Mobile Loaves & Fishes ($)
Do you plan to solicit in-kind donations?
Yes
No
If yes, please describe
Do you plan to publicize the event? If so, how?
Event Coordinator Name
Date
I have read and understand the Mobile Loaves & Fishes Fundraising Guidlines
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