Registration Form for

Night to Spark Change

Thank you for your interest in hosting an event for the Night to Spark Change! Please fill out the form below to register your event.

First name*

Last name*

Email*

Phone*

Company name

Date of Your Gathering*

Expected Number of Attendees*

Fundraising Goal

$250

$500

$1000

Other

Other Amount

How Do You Plan to Promote Your Event?

Social Media

Email Newsletters

Flyers/Posters

Word of Mouth

Other

How Will You Collect Donations?

Cash

Credit/Debit Card

Online Via QR Code

Other

Is There Anything Else You'd Like Us to Know?

Terms and Conditions

I acknowledge that I have read and understood the terms and conditions above.

Signature

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