Registration Application For An Individual Professional Solicitor - South Carolina Secretary Of State
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1
2SOUTH CAROLINA
SECRETARY OF STATE
PUBLIC CHARITIES DIVISION
REGISTRATION APPLICATION
I
P
S
NDIVIDUAL
ROFESSIONAL
OLICITOR
Filing Instructions
Include the $50.00 filing fee, payable to South Carolina Secretary of State, with this application.
Our office will not accept more than five individual solicitor applications to be paid with a single check.
This application must be completed in its entirety. If there are any questions not answered, this form
will be returned for correction.
Please contact our office with any questions regarding this form at 803-734-1790 or charities@sos.sc.gov.
Mail to: South Carolina Secretary of State, Public Charities Division, 1205 Pendleton St., Suite 525,
Columbia, SC 29201.
Check one:
[ ] Initial Registration
[ ] Renewal
Individual Solicitor’s ID: ______________
(Renewal only)
1. Full Name of Individual Professional Solicitor: ________________________________________________
A. Home Address of Applicant:
___________________________________________________________________________________
Street Address, City, State, Zip Code
2. Your employer’s company name and contact information: ________________________________________
Fundraising Company Name
_______________________________________________________________________________________
Contact Name
Contact Title
_______________________________________________________________________________________
Contact Address, City, State, Zip Code
_______________________________________________________________________________________
Contact Phone
Contact Email
3. List all other governmental authorities with which you are registered as a professional solicitor:
______________________________________________________________________________________
______________________________________________________________________________________
4. List any other charitable organizations for which you have solicited donations as a professional solicitor in the
State of South Carolina for the previous three years. Attach a separate sheet if necessary.
______________________________________________________________________________________
______________________________________________________________________________________
5. Has your authority to solicit contributions been denied, cancelled, suspended or revoked, or has any disciplinary
or legal action been taken against you by any governmental authority or is any action pending against you in relation to
any fundraising activity? ____No ____ Yes If yes, provide a full description. Attach a separate sheet if necessary.
_______________________________________________________________________________________
_______________________________________________________________________________________
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