Flyer Request
Must be received in home office 45 days prior to event or R.S.V.P. date.
Chapter #
Event Title:
Event Date:
Event Time
Place:
Address:
City, State
R.S.V.P. Date:
Cost, If any
Is this a Matching Funds event?
Yes
No
If yes, who or what will benefit?
What will funds be used for:
This event is for:
Join Hands Day
Make a Difference Day
Adopt-a-School
Event Contact Person:
Phone #
I am requesting a family activity bonus for this event (limit 2 per year).
Yes
No
Please include any other information that would help encourage people to attend.
Person Submitting form
Phone #
Email:
Before submitting your request,
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