Third Party Fundraising Event Application

Events planned by community groups and individuals are a vital source of funds for the Adult Congenital Heart Association. Your generosity can help ACHA continue our mission to improve the quality of life and extend the lives of adults with congenital heart defects through education, outreach, advocacy, and promotion of research.

HOST INFORMATION

Name:*

Email Address:*

Phone Number:*

Cell Phone Number:

Country:*

Address (1):*

Address (2):

City:*

State/Region:*

Zip/Postal Code:*

EVENT INFORMATION

Proposed Event Name:*

Brief Description of Event:*

Proposed Location:

Event Date:

Select Date

Event Time:

Target Audience:

Fundraising Goal:*

Estimated Attendance:

PUBLICITY

How will this event be publicized?:

Third Party Fundraising Event Application

HOST INFORMATION

EVENT INFORMATION

PUBLICITY

PLEASE DESCRIBE HOW ACHA CAN ASSIST IN YOUR FUNDRAISING EFFORTS