*Name of Group:

*Name of Fundraising Leader:

*Daytime Phone:

*Email Address:

*Residential or Commercial:

*Address 1:

Address 2:

*City:

*State:

*Zip:

*Have you watched our videos?

*How many "Easy Dozens" will each person sell?

see our Profit Calculator

*What is your "Easy Dozens" sales goal? ($)

*How many brochures are needed?

*Date fundraiser begins:

*Date fundraiser ends:

If Other:

*How Did You Hear About Us:

If Other:

Please note: It is your responsibility to collect any taxes applicable in your state. Within Tennessee, any organizations without a Tax ID # will be charged 9.25% tax.