Special Events Proposal Form

* = Required Information

* Proposed Event/Promotion:
* Date(s)/time:
* Location:
* Sponsoring Organization, Business:
* Contact Person:
  Title:
* Address:
* City:
* State:
* Zip:
* Phone: ( )
  Fax: ( )
* E-mail:
* Event description:
* How will you raise money through this event?
* Have you formed a committee to help organize this event? Yes  No
* How will you promote this event?
* Have you held a fundraiser for us before? Yes  No
  If yes, please explain:
* Why did you choose to do a special event or promotion for Children's Hospital?
* Fund raising goal: $
* Projected expenses: $
* Estimated gift to Children's Hospital and Health System Foundation: $
* Is Children's Hospital and Health System Foundation the sole beneficiary of proceeds? Yes  No
  If not, please explain.
  Do you plan to seek gifts or donations from local businesses? Yes  No
  If yes, please provide a list of potential businesses. Children's Hospital and Health System Foundation staff will review and approve the list of businesses to be approached.
* Please specify a designated program(s) you would like your contribution to fund.
 
Area of Greatest Need Child Abuse Care Fund Genetic Research
Bone Marrow Transplant Children's Health Education Center Neonatal Intensive Care Unit
Cancer Care Children's Research Institute Pain Management
Cardiology Diabetes Research Sickle Cell

If you would like to support a program not listed, please call (414) 266-6320 for additional programs.

Agreement for Special Event or Promotion:

  • All publicity for proposed events must be approved by Children's Hospital and Health System Foundation before it is released, printed, etc.
  • The proceeds and a final accounting of the event must be submitted within 30 days after the event.
  • Children's Hospital and the Children's Miracle Network and their logos are service marks of Children's Hospital of Wisconsin and cannot be used without written permission.