Third Party Event Proposal Form

Thank you for considering Kennedy Krieger Institute as the beneficiary of your event.

We look forward to working with you to create a successful event.

Please note: If you wish to sponsor an event on behalf of the Kennedy Krieger Institute, you must complete this application for review

by the Kennedy Krieger Foundation. Completion of this form does not guarantee approval.

Event Details

Event/Fundraiser Name: ______

Event Description: ______

______

Event Date (Rain Date): ______Start & End Time: ______

Projected Attendance: ______Capacity: ______Inside Outside

Event Location (Address): ______

______

Event website: ______

Will any other charitable organizations benefit from this event? (If yes, please name and describe how they will benefit)

______

______

How will the money be raised (donations, sponsorships, ticket sales, percentage of sales, etc.?)

______

What additional fundraising activities will take place at this event?

RafflesAuctionsDoor prizes

Other (Please describe) ______

Funds raised should be used for: Area of greatest need within the Institute

Other designation: ______

Is this event in honor of someone? (If yes, please provide their name)______

Has this event been held before? (If so, when?) ______

Contact Information

Please check one:IndividualBusiness/CorporationOrganization/Group

Name of Business/Organization: ______

Organization Address: ______

Organization Website: ______

Is your organization a registered charity in its own right? Yes No

If yes, what is your charitable registration number? ______

Contact Name: ______

Email: ______

Telephone: (Work) ______(Cell) ______

Preferred Method of contact: EmailWorkCell

Alternate Contact Name: ______

Email: ______

Telephone: (Work) ______(Cell) ______

Why did you choose Kennedy Krieger Institute as the beneficiary of your fundraiser? ______

______

______

Publicity & Promotion

Kennedy Krieger requires the review and approval of all materials that include our name and/or logo. Please check the type of promotional activity you will be involved in:

Press releases will be sent to: ______

Flyers will be distributed to: ______

Public Service Announcements will be sent to: ______

Other: ______

Other

Please provide a list of business you plan to solicit for gifts/sponsorships (if applicable):

______

______

______

______

Projected Expenses & Income

Costs projected: ______

Income projected: ______

Estimated donation: ______

Expected date of delivery of proceeds (Should be within 45 days of event): ______

What other support/services would you ask of Kennedy Krieger Institute?

Brochures and/or Institute/program collateral

Return envelopes for donations

Giveaways (limited quantities available)

Donation webpage

Event posting and link on Kennedy Krieger Events Page

Event promotion on Kennedy Krieger Institute’s Facebook Page

Other:______

______

______

Required Additional Documentation

Information regarding ticket prices, sponsorship levels & benefits, etc.

List of all individuals & organizations being solicited for Sponsorships and In-kind Donations

Proposed Budget: Income & Expenses

Signed: ______Application Date: ______

Please return the completed form to:

Attn: Special Events

Kennedy Krieger Foundation

707 North Broadway

Baltimore, MD 21205

443-923-7320 (fax) or .

If you have any questions regarding this application, please contact the Kennedy Krieger Foundation at 443-923-7300.