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Briefly describe your organization:
(Maximum response 255 chars, approx. 5 rows of text)
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Why have you selected Texas Children's Hospital to receive the funds raised?
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Are you or the person hosting this event an employee of Texas Children's Hospital?
Please select response
Yes
No
Event and Fundraiser Information
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How would you best describe this event from the following options?
Please select response
One-time event
Annual event
Ongoing fundraiser
Fundraiser to donate items, not money
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Name of proposed event or fundraiser:
(Maximum response 255 chars, approx. 5 rows of text)
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Date of event:
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Is the event:
Please select response
Open to the public
By invitation only
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Have you formed a committee to help organize this event or fundraiser?
Please select response
Yes
No
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Who will support you in your efforts?
(Maximum response 255 chars, approx. 5 rows of text)
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Is Texas Children's Hospital the sole beneficiary?
Please select response
Yes
No
If no, please list other beneficiaries:
(Maximum response 255 chars, approx. 5 rows of text)
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How will the funds be raised?
Please select response
Ticket sales
Online
Sponsorships
Auction
Donations
Other
If you selected "Other," how will the funds be raised?
(Maximum response 255 chars, approx. 5 rows of text)
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Who will you solicit?
Please select response
Friends
Family
Clients
Other
If you selected "Other," who will you solicit?
(Maximum response 255 chars, approx. 5 rows of text)
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How will expenses be paid?
Please select response
From proceeds
By event organizer
If you're unsure of the exact amounts, please round your next three answers to the nearest $50.
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Anticipated total funds raised:
Please select response
$1-$999
$1,000-$9,999
$10,000 - $24,999
$25,000 +
$100,000 +
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Anticipated total expenses:
Please select response
$0
$1-$999
$1,000-$9,999
$10,000 - $24,999
$25,000 +
$100,000 +
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Anticipated donation to Texas Children's Hospital:
Please select response
$1-$999
$1,000-$9,999
$10,000 - $24,999
$25,000 +
$100,000 +
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Where would you like your funds directed?
Please select response
Greatest Need
Charity Care
Relief Fund for Texas Children's Employees
Texas Children's Cancer and Hematology Centers
Texas Children's Heart Center
Texas Children's Neonatal Intensive Care Unit
Texas Children's Hospital The Woodlands
Texas Children's Hospital West Houston
Other
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How will you promote this event or fundraiser?
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I understand that under Texas State Law, raffles are allowed only if sponsored by a 501(c3) organization. Texas Children's Hospital is unable to support a third-party raffle.
Please select response
I agree
I disagree
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I agree that Texas Children's Hospital will receive all revenues from my fundraiser within 60 days of the event.
Please select response
I agree
I disagree
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I agree that I will submit all proposed printed materials and publicity for the fundraiser for approval by Texas Children's prior to printing or distributing.
Please select response
I agree
I disagree
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Today's Date
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