October 26, 2014

Submissions due by June 27, 2014

Non-profit Organization Name:
501(c)3 Tax ID Number (required):
Short Description of Nonprofit:
Executive Director:
Phone Number: (123) 456-7890
Address:
City:
Zip Code:
Website:
Signature Fundraising Event Title:
Date of Signature Event:
Location of Signature Event:
Signature Event Chairperson:
Ticket Price for Signature Event:
Contact Person, Phone and Email for Signature Event (only phone will be published):
Other Event:
Other Event Date:
Other Event Location:


This organization agrees to distribute an email blast to its own list of subscribers directing them to a free, digital version of Gulfshore Life’s 2013:

 Yes
 No

Approximate number of subscribers on organization’s email distribution list:
Name of Respondent (for fact-checking purposes only; will not be published):
Your Position at Organization:
Your Phone Number: (123) 456-7890
Email Address: