Fillable Community Initiative Proposal Form Calgary Health Trust printable pdf download

COMMUNITY INITIATIVE TOOLKIT

Community Initiative Proposal Form

Note: Application must be approved by Calgary Health Trust prior to promoting or hosting the event.

Today’s Date: ______________________________________________________________________________________________________________

1. Your information:

Name of Group/Company Planning Community Initiative: ____________________________________________________________________

Primary Contact: ___________________________________________

Role: _______________________________________________________

Mailing Address: ____________________________________________________________________________________________________________

City: _______________________________________________________ Postal Code: _________________________________________________

Home Tel: ______________________________ Business: _______________________________

Cell: ________________________________

E-mail Address: ____________________________________________________________________________________________________________

2. Event/ Initiative information:

Name of Proposed Initiative: _______________________________________________________________________________________________

Start Date: _________________________________________________ End Date: ___________________________________________________

Start Time: _________________________________________________ End Time: ___________________________________________________

Name of Venue: ___________________________________________________________________________________________________________

Location of Event: _________________________________________________________________________________________________________

Address: ________________________________________________________________________ Postal Code: ___________________________

3. Briefly describe the event and how the funds will be raised.

________________________________________________________________________________________________________________

4. How many people do you expect to attend the event? ________________

5. What is your expected net revenue for this event? (Please see Budget Guideline for assistance.) $ ________________

6. Are you planning on hosting a raffle? (50/50 or Prize raffle) YES

7. Do you understand and agree that all event costs are to be covered by the event organizer and only proceeds

are to be directed to the Calgary Health Trust? YES

8. Does the community group agree that the Calgary Health Trust will receive all revenues from the event within

30 days of the event? YES

800, 11012 Macleod Trail SE, Calgary AB T2J 6A5

calgaryhealthtrust.ca

Phone: 403-943-0603

Community Initiative Proposal Form Calgary Health Trust