Sign Up Fundraiser – A Good Fundraiser

A. Organization Information

Organization Name *

Legal Entity Name (if different)

EIN / Tax ID Number *

Type of Organization

Year Established

Website URL

Mission Statement

Full Name *

Title / Role

Email Address *

Phone Number *

Mailing Address *

Billing Address (if different)

Bank Account Holder Name *

Bank Routing Number *

Bank Account Number *

Upload Bank Verification *

Fundraiser Name *

Primary Color

Secondary Color

Short Message to Donors

I confirm that the information provided is accurate and that this form serves as our agreement for participation in the program.