Planning a fundraiser? We would love to know more about the event and to assist in the promotion. Please complete the form below to have a representive from GRHF contact you.

Contact Information:
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Company/Organization Name:
*Contact First Name:
*Contact Last Name:
Title:
*Telephone:
Fax:
†Email:
*Address:
*City:
*Postal Code:
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General Information:
Please indicate the category which best describes your organization:
Community Group   Business   School Service Club   Individual Other
Name of Event:
Date of Event:
Time of Event:
Location:
How many years has this event been held:
Details/description of this event:
Will a raffle license be required:
Yes   No
Will a liquor license be required:
Yes   No
How do you plan to promote your event:
Does your organization plan to use the name and/or logo of the Grand River Hospital Foundation or the Grand River Hospital (Freeport or K-W Health Centre) in your printed materials and in your publicity:
No   Yes How:
Is there a specific area of the Hospital to which you would like to designate the proceeds:
Will other charitable organizations also benefit from this special event or promotion:
No   Yes Please list them:
Estimated income from the special event:
Estimated expenses from the special event:
Estimated donation to the Foundation:
Date you anticipate the Foundation will recieve the donation:
Would you like representation from the Foundation at your event:
Yes   No
Would you like to present a cheque to Foundation representatives:
Yes   No
May the Foundation recognize your organization/company's efforts in our donor recognition program:
Yes   No