Susan G. Komen for the Cure® Tri-Cities Affiliate Survey - Tri-Cities

Tri-Cities - Relationship Proposal Form

Thank you for considering Susan G. Komen for the Cure® to be the beneficiary of your revenue generating efforts and ideas! Please take a moment to complete this form so that we may give your proposal the consideration it deserves. We work hard to create corporate and 3rd party relationships that are mutually beneficial thus the more we know about your plans the more thorough the consideration by the Review Committee. Please complete this form and click "submit" when you are done.

Step 1: Tell us about you and/or your organization

*1.

Question - Required - Sponsoring organization's name:

*2.

Question - Required - Nature of the business:

3.

Question - Not Required - Last name, First name:

*4.

Question - Required - Address, City, State, ZIP

*5.

Question - Required - Phone:

*6.

Question - Required - Best time to call:

*7.

Question - Required - Email:

8.

Question - Not Required - Website:

Step 2: Tell us how money will be raised for Komen for the Cure

*9.

Question - Required - Name of revenue generation idea, event, program:

*10.

Question - Required - How will the funds be raised: (sales, pledges, etc):

*11.

Question - Required - Date/location of fundraising activities:

*12.

Question - Required - National or local focus:

*13.

Question - Required - Duration of fundraising activities:

*14.

Question - Required - How much money do you expect to raise?

*15.

Question - Required - Anticipated net proceeds to Komen:

STEP 3: Tell us about the proposal elements and logistics

*16.

Question - Required - Describe how you plan to raise the funds? Please also list your estimated revenue and expenses for this project.

*17.

Question - Required - What are the costs associated with this idea? Will Komen be responsible for the expenses? Do you envision requesting financial assistance from Komen?

*18.

Question - Required - How do you propose to use Komen's name and/or logo? (ie. solicitation letters, invitations, flyers, press releases, point of purchase materials, web site, newsletter, other)

*19.

Question - Required - Have you ever coordinated or been involved in a project like this before? If so, please describe.

Komen Information

Komen does not endorse products or services of any kind.
Because of IRS regulations, Komen is unable to assist with promotion or advertising of your company, event or product.
Use of the Komen logo requires a legal contract. That process takes 2 months at a minimum.
Relationship proposals are reviewed by the Relationship Review Committee. This committee meets once a month.
If your proposal is approved by this committee a Komen representative will contact you for more information.

Disclosure
For the protection of the consumer, the Better Business Bureau requires that the anticipated amount or percentage of the proceeds from sales to benefit a charity be posted at the point of purchase (i.e. $1 or 5 % of each purchase or ticket benefits X charity).

Using the Komen name or logo
Komen’s logo is trademarked, and any use without express written permission is illegal. Use this form to request permission.

OUR PROMISE
The Susan G. Komen for the Cure promise: to save lives and end breast cancer forever by empowering people, ensuring quality care for all and energizing science to find the cures.

STEP 4: Review and submit your proposal

20.

Signature:

*

Name:

First Required	Last Required

*

Email: Required

Phone Number: