(*) denotes required information.

* Organization:

Date(s) of Event:

Location of Event:

Co-Sponsoring Organization (if applicable):

Benefiting Organization(s):

Contact Person:

Title/Short Description of Event:
 

Money Raised:

Total Amount of Expenses:

Total Amount of Money Donated:

Other Goods/Services Donated (ex: Canned goods, clothing, etc.:
 

Time for Planning and Implementing the Event:

Chapter Representative Completing Form: