Organizer/Host Contact InformationName(Required) Daytime Phone Number(Required) Email(Required) City/Province(Required) Postal Code(Required) Company/Organization Information (If Applicable)Company/Organization Name Mailing Address Daytime Phone Number Email Company/Organization Website Fundraiser DetailsInitiative/Event Name Event Date DecriptionTell us about your event, type of fundraiser, and why you are choosing to support ACWSEvent Start Time Location/Address Number of Attendees Expected Fundraising Goal ($ Amount) Licensing Information (If Applicable)Liquor License Number Gaming License Number Insurance Provider ACWS RequestsDo you request an ACWS representative to attend your event? (If Applicable) Yes No If yes, do you require them to speak or make a presentation? (Please provide a brief overview)*Please note that we cannot guarantee that an ACWS representative will attend your event, but we will do our best to accommodate all requests based on availability 78424Δ