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Philanthropy
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Community Fundraiser Guidelines
Community Fundraising Event Form

Community Fundraising Event Form

Name of Organization or company planning event

Contact Person

Title

Mailing Address

Organization/Company Website

Home Phone

Work Phone

Cell Phone

Email

Is your organization a

Nonprofit

For-profit

Briefly describe your organization or company

Event Information

Is the event

One-time event

Annual event

On-going project

Open to the public

By invitation only

Name of the event

Date

Time

Location

Briefly describe the event

Why did you choose Wake Forest Baptist Medical Center to be the beneficiary of your event?

Have you held a fundraising event before?

Yes

No

Do you need a letter of support from Wake Forest Baptist Medical Center?

Yes

No

Do you plan on using the Wake Forest Baptist Medical Center logo?

Yes

No

Do you have a Facebook page for the event?

Yes

No

How will you promote this event?

How will the funds be raised?

Ticket Sales

Sponsorships

Auction/Raffle

Other

If other, please explain

Who will you solicit?

Friends

Family

Clients

Local Businesses

If businesses will be solicited, please list their names

Is Wake Forest Baptist Medical Center the sole beneficiary?

Yes

No

If no, please list other beneficiaries

Where would you like your funds directed?

Brenner Children’s Hospital Fund

Dean’s Fund for Education

Diabetes Research Fund

Discovery Fund the Comprehensive Cancer Center

Excellence in Heart and Vascular Fund

Gerontology Support and Research Fund

Regenerative Medicine Fund

If other, please list

How will expenses be paid?

From proceeds

By event organizer

Anticipated total funds raised

Anticipated total expenses

Anticipated donation

I agree that Wake Forest Baptist Medical Center will receive proceeds from the event within 30 days of the event.

I agree that all printed materials and publicity for the event must be approved by Wake Forest Baptist Medical Center prior to being released, printed, etc.

I have read the guidelines for community fundraisers for Wake Forest Baptist Medical Center and agree to follow them as stated.

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Community Fundraiser Guidelines
Community Fundraising Event Form

For more information

Cindy Caines
ccaines@wakehealth.edu
336-716-6285

Katherine Haley
khaley@wakehealth.edu
336-713-7657

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Learn more about our nondiscrimination policy and services available to you.

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Disclaimer: The information on this website is for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, evaluation or care from your physician or other qualified health care provider.

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