Third Party Event Form Organization Name Contact Name(Required) First Last Contact Email(Required) Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Organization Website Contact Phone(Required)Event InformationEvent Name Event Start Date MM slash DD slash YYYY Event End Date MM slash DD slash YYYY Event Start Time Hours : Minutes AM PM Event End Time Hours : Minutes AM PM Event Location Anticipated Number of People in AttendanceTarget Audience Adults Families Children Veterans Other (describe below) Target Audience Other Event DescriptionDescribe your planned event including the specific event goal(s).How much money do you hope to raise for Freedom Service Dogs? Freedom Service Dogs InvolvementDo you request Freedom Service Dogs staff and/or volunteers to attend the event? Yes No Do you request a service dog-in-training to attend the event? Yes No Although we try our best to participate in all events, due to the high volume of requests for staff/volunteers/dogs to attend events, we cannot guarantee attendance at your event. Please note that it is more difficult to ensure Freedom Service Dogs attendance if your event is on an evening or weekend.Please describe how you will utilize Freedom Service Dogs staff/volunteers/dogs at your event:Financial OverviewIs Freedom Service Dogs the sole beneficiary of the event? Yes No If no, please list other beneficiaries:What are the expected NET proceeds from the event?Notifications and Acknowledgements(Required)- I understand that this is a proposal and is NOT a guarantee that Freedom Service Dogs' staff, volunteers, and/or dogs will have the ability to attend the event. I also understand that the availability of our dogs-in-training may change at the last minute. - I understand that written approval must be issued by Freedom Service Dogs before event participation can be guaranteed. - I understand that it may take up to two weeks to be reviewed and approved. I have read the above statements and agree. On behalf of Freedom Service Dogs, thank you for your interest in conducting a third party fundraising event on our behalf. Your support will help us to rescue more dogs from shelters and train them to be service dogs for deserving clients on the wait list. We look forward to working with you!CommentsThis field is for validation purposes and should be left unchanged.
