Fundraising Event Request Form

Thank you for your interest in organizing a fundraising event for the American Hearing Impaired Hockey Association. Please complete the information below and submit it to AHIHA. You will be contacted shortly with additional information.

Please contact Kevin Delaney at kdelaney@ahiha.org, if you have any questions.

Please make checks payable to: AHIHA

Please mail checks to:

AHIHA
c/o Kevin Delaney
9345 N Harding Ave.
Evanston, IL 60203

Registration Information

Player Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone Number *

Email *

Beginning Date of Event *

Ending Date of Event *

Who Will Be Running Event? *

Describe Details of Event *

Do You Need Brochures? *

Would you like to be aknowledged for your event at the Wednesday night banquet? *

ALL FUNDS MUST BE MAILED WITH A COPY OF THIS FUNDRAISING FORM, TO KEVIN DELANEY WITHIN TWO WEEKS OF THE ENDING DATE OF THE EVENT.

Agree *

I have read and agree to all terms and conditions above

Name