New Account Sign Up Form

Use this form to sign your group up for a fundraising program.
Do not use this form if you are in need of samples or more information before you can commit.
For samples and brochures please use our Request Free Information form or call 1-800-234-5561.

Please tell us about your up coming sale:
	Product / Program:
	Profit Goal: $
	Number of Participants:
	Fundraiser Start Date:	/ /
	Date Sales Materials Needed:	/ /
	Payment Method:
Your Information (Primary Sponsor):
	Name:	*
	Title:
	E-mail Address:	*
	Home Phone:	( ) -
	Cell Phone:	( ) -
	Work Phone:	( ) -
	Preferred Contact?	Home Cell Work
	When is the best time to reach you?	Customer Service hours are 8:30 am to 5:30 pm Monday through Friday EST.
	Are you the decision maker?	Yes No
School or Organization Information:
	Organization Type:	Examples: PTA/PTO, Band, Safety Patrol, Youth Soccer, Etc.
	Name:
	Phone:	( ) -
	Fax:	( ) -
	Mailing Address:
	Street Address:	Cannot ship to a P.O. Box
	City:
	State:	(USA only)
	Country:
	Zip Code:
	Shipping Address:	Same as mailing address
	Street Address:	Cannot ship to a P.O. Box
	City:
	State:	(USA only)
	Country:
	Zip Code:
	Total School Enrollment:
	School Principal's Name:
	School Principal's Phone:	( ) - Ext
	School Principal's E-mail:
Contact #2
	Name:
	E-mail Address:
	Home Phone:	( ) -
	Cell Phone:	( ) -
	Work Phone:	( ) -
	Preferred Contact?	Home Cell Work
Contact #3
	Name:
	E-mail Address:
	Home Phone:	( ) -
	Cell Phone:	( ) -
	Work Phone:	( ) -
	Preferred Contact?	Home Cell Work
Comments / Additional Information:
	How did you hear about us?
	Prior Fundraising Product:
	Prior Fundraising Company:
	Questions or Comments:
*Indicates a required field.
By submitting this form, you acknowledge that you are authorized to sign up your group to begin a fundraiser. Submission of this form also indicates your acceptance of the applicable Terms and Conditions.