Survey - Community Partner Program Application - Children's Hospital Colorado Foundation

Thank you for your interest in fundraising for Children's Hospital Colorado Foundation. The purpose of this form is to gather as much information as possible about your proposed fundraising idea. If you have any questions, don't hesitate to contact us at events@childrenscoloradofoundation.org.

Submit this form at least 60 days before your fundraising initiative begins. Our Community Partner Committee will review and evaluate your request and you will receive a reply within five business days.

Until your initiative is approved, use of the Children's Hospital Colorado name, logo, or any of its licensed marks is strictly prohibited. Please read our Community Partner Guidelines and our Logo and Brand Standards.

Children's Hospital Colorado Foundation generally does not accept initiatives which promote the following:

Adult content
Alcoholic beverages
Books
CDs/Music
Dangerous products/firearms
Live animals
Tobacco
Toxic substances
Pharmaceutical/medical supplies
Marijuana
Photography
Personal services

Please fill out your contact information


	Title:
*	First Name: Required
*	Last Name: Required
*	Email: Required
*	Street 1: Required
*	City: Required
*	State / Province: Required
*	ZIP / Postal Code: Required
	Country:
*	Phone Number: Required
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Question - Not Required - Company/Organization:

*

Question - Required - Are you a 501c3 organization?:

Question - Not Required - If yes, what is your 501c3 number? :

*

Question - Required - Have you held this initiative before to benefit Children's Hospital Colorado?:

Question - Not Required - Please list the name and date of the last initiative:

(Maximum response 255 chars, approx. 5 rows of text)

*

Question - Required - Describe your proposed fundraising initiative:

(Maximum response 255 chars, approx. 5 rows of text)

Question - Not Required - Initiative/Event name:

(Maximum response 255 chars, approx. 5 rows of text)

*

Question - Required - Is Children's Hospital Colorado the sole beneficiary?:

*

Question - Required - Are there any other charities involved?:

Question - Not Required - If other charities are involved or are beneficiaries, please explain:

(Maximum response 255 chars, approx. 5 rows of text)

*

Question - Required - Select the type of proposal that most closely matches your fundraising idea.:

Question - Not Required - If "other," please explain more about this type of proposal:

(Maximum response 255 chars, approx. 5 rows of text)

Question - Not Required - Will this fundraising event be open to the public?:

Private/invitation only

Open to the public

*

Question - Required - Beginning date:

*

Question - Required - End date:

Question - Not Required - Start time:

Question - Not Required - End time:

Question - Not Required - Event venue:

(Maximum response 255 chars, approx. 5 rows of text)

Question - Not Required - Event address (name, street address, city, state, zip):

(Maximum response 255 chars, approx. 5 rows of text)

Question - Not Required - Event website (enter "none" or "n/a" if not applicable):

*

Question - Required - Event fundraising goal:

(Maximum response 255 chars, approx. 5 rows of text)

*

Question - Required - Where would you like the funds raised to be designated? (Note: Only one designation can be selected per fundraising initiative):

Question - Not Required - If "other," please explain the fund designation:

Question - Not Required - If your fundraising initiative is based on percent of sales, what percent will be donated to Children's Colorado?:

Question - Not Required - Has your business been established for at least one year?:

Question - Not Required - This fundraising initiative will not utilize telemarketing or door-to-door sales of the product or service:

Question - Not Required - This fundraising initiative is not based upon obtaining, using names of, or soliciting Children's Colorado's donors, vendors, partners, employees or volunteers:

Question - Not Required - Would your company like to offer a discount to all Children's Hospital Colorado employees listed on our hospital's internal "Discount and Opportunities" page? (pending approval):

Question - Not Required - Major source of income? Check all that apply:
Please make at least 1 selection from the choices below.

	Admission/ticket sales
	Auctions (Note: Sales tax must be collected on all tangible auction items - gift certificates do not apply)
	Monetary/cash donation collection
	Sale (baked goods, crafts, etc.) (Note: Sales tax must be collected)
	Promotions/percentage of sales to benefit Children's Hospital Colorado
	Sponsorships (Note: Sponsor levels and benefits must be reviewed and approved)
	Raffle/Door Prize (see note below about raffles)
	Other (explain below)

Question - Not Required - If "other," please explain other funding sources:

(Maximum response 255 chars, approx. 5 rows of text)

Question - Not Required - If you selected admission/ticket sales as a major source of income above, please tell us your ticket price, and the fair market value of any goods or services received by attendees. If you will not have ticket sales, note "n/a":

(Maximum response 255 chars, approx. 5 rows of text)

IMPORTANT NOTE REGARDING RAFFLES: Children's Hospital Colorado DOES NOT hold a raffle license. Any event benefiting Children's Hospital Colorado must obtain their own raffle license. Your Children's Hospital Colorado Foundation event manager will be able to discuss other fundraising alternatives that can be held legally under Colorado State Law.

Question - Not Required - Intention to hold a raffle:

By checking here, I certify that I agree not to hold a raffle.

By checking here, I certify that my organization has received a current raffle license and will follow all raffle laws according to Colorado State Law. I will provide my license information below.

Question - Not Required - Please submit the name of the organization holding the raffle license, the license number, and the raffle manager name:

*

Question - Required - Will you obtain any/all necessary permits and licenses for your fundraising initiative?:

*

Question - Required - How do you plan to promote your fundraising initiative?:

(Maximum response 255 chars, approx. 5 rows of text)

*

Question - Required - How do you plan to use the benefiting Children's Hospital Colorado logo? (Note: All logo usage must be sent over to event manager for approval prior to promoting the initiative.):

(Maximum response 255 chars, approx. 5 rows of text)

*

Question - Required - What do you think you will need to support your initiative?:
Please make at least 1 selection from the choices below.

	Online donation form
	Online registration form for ticket and sponsorship sales
	Event listing on Foundation website
	Other (explain below)

Question - Not Required - If "other," please explain your request:

(Maximum response 255 chars, approx. 5 rows of text)

Question - Not Required - Please note any additional information:

(Maximum response 255 chars, approx. 5 rows of text)

AGREEMENT:

Please click each "I agree" button to agree to each term below:

*

Question - Required - Children's Hospital Colorado Foundation welcomes fundraising initiatives for review, but choosing to submit a proposal does not obligate the Children's Colorado Foundation to enter into a fundraising program with you. Additionally, you should agree to give all funds raised to Children's Hospital Colorado Foundation no later than 30 days after your program has ended.

I agree

*

Question - Required - By submitting a fundraising initiative you agree to assume all risks and liabilities associated with the proposal and hereby release and hold harmless Children's Hospital Colorado Foundation entities, their directors, officers, employees, agents, and successors from and against any and all claims, damages, liabilities, costs, and expenses, including reasonable attorney's fees arising out of or in connection with the event, including without limitation any personal injuries or damages to property that may occur in conjunction with your fundraising initiative.

I agree

*

Question - Required - Although Children's Colorado Foundation actively encourages community partner fundraising events and promotions, we must approve all initiatives in advance. The Foundation and/or hospital maintain the right to decline initiatives. This is an important safeguard in preserving the integrity of the name and reputation of Children's Hospital Colorado, Children's Hospital Colorado Foundation, and Children's Miracle Network Hospitals, as well as our commitment to our donors.

I agree

*

Question - Required - If Children's Colorado Foundation agrees to enter into a fundraising program with you, all written, electronic or printed fundraising program materials containing Children's Hospital Colorado and Children's Miracle Network Hospitals logos or trademarks, before and after your fundraising begins, must comply with graphic standards and must be submitted to us for approval before printing or circulation.

I agree

*

Question - Required - By submitting this Community Partner Program Application, you certify that you have reviewed and agree to the Children's Hospital Colorado Foundation Community Partner Guidelines and the Children's Hospital Colorado Foundation Logo and Brand Standards. (See links at the top of this form)

I agree

Please click "Submit" below complete your application.

Question - Not Required - Please submit the name of the organization holding the raffle license, the license number, and the raffle manager name: 01

(Maximum response 255 chars, approx. 5 rows of text)

Question - Not Required - Please submit the name of the organization holding the raffle license, the license number, and the raffle manager name: 02

(Maximum response 255 chars, approx. 5 rows of text)

Question - Not Required - Please submit the name of the organization holding the raffle license, the license number, and the raffle manager name: 03

(Maximum response 255 chars, approx. 5 rows of text)

Question - Not Required - Please submit the name of the organization holding the raffle license, the license number, and the raffle manager name: 04

(Maximum response 255 chars, approx. 5 rows of text)