Community Fundraising Application

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Thank you for your interest in raising funds for Children's Hospital Los Angeles! We are a 501(c)3 nonprofit organization that relies on the generosity of community supporters like you to provide the highest quality health care for children each day. For more information about whom to contact and about how to run a successful event, please check our "Host an Event" page.

* required information

Complete the Community Fundraising Events Application

Name of Group/Organization Planning Event:*
Name of Individual in charge of Event:*
Your First Name:*
Your Last Name:*
Address Line 1:*
Address Line 2:
City:*
State:*
ZIP/Postal Code:*
Phone:
Email:*

Name of Event:*
Proposed Date of Event:	(mm/dd/yyyy)
Proposed Time of Event:
Event Type:*
If other, please describe:
Is the event:*	Open to the public By Invitation only
Ticket Price::*	$
Fair Market Value (FMV):*	$
	*FMV is the goods and services the participant will receive for attending. Even if the event is underwritten, goods and services need to be disclosed.
Financial Overview
Budget Estimate (Organization/Individual not liable for amount listed):
Food/Beverage:*	$
Venue:*	$
Entertainment:*	$
Permit/Insurance fees:*	$
Printing:*	$
Supplies:*	$
Other Budget:	$
What are the estimated proceeds to benefit Children's Hospital Los Angeles?:*	$
Please provide a brief description of your proposed event:*
How will the event be publicized? (press releases, advertisements, PSAs, promotional flyers, emails, etc):*
Will you have an event website:*	Yes No
Website address:
Are there any other charities involved?:*	Yes No
If yes, please explain other charities' involvement in your event:
Is this, or will this be an annual event benefiting Children's Hospital Los Angeles?:*	Yes No
Thank you for choosing Children's Hospital Los Angeles to be the beneficiary of your event. Is there a special reason why you selected our cause?:*
Do you plan to use the hospital's logo as part of your advertising for the event or on any of your event-related materials?:*	Yes No
If you answered Yes above, please describe How and Where you would use the hospital's logo:
Are you able to provide a sample or proof you are able to share to demonstrate your use?:	Yes No
Community Event Guidelines
The hospital encourages fundraising events that are consistent with our image, mission and core values. To conduct an event you are required to complete an application. Once you submit the application, please allow a minimum of 5 days for review and response. If the application is approved, we will provide you with a Letter of Agreement. This letter may be shown to potential donors and sponsors. If the application is approved, you will be required to complete the Notice of Intention to Solicit Charitable Contributions form to be filed with the City of Los Angeles. A donation of a portion of net proceeds, rather than full amount, must state exactly how much, either in a percentage or specific dollar amount on the application. The use of the hospital’s name, Children's Hospital Los Angeles, or logo on any materials, including website, must be approved prior to production. Children's Hospital Los Angeles shall not incur costs for event production or promotion. The organizer is responsible for obtaining appropriate licenses (i.e. raffles, liquor permits, etc.) and insurance. The hospital shall receive all proceeds within 30 days of the completion of the event. The organizer agrees to submit a one-page final report upon delivery of event proceeds. Tax receipts can only be given to donations or gifts in-kind made directly to Children's Hospital Los Angeles. The organizer agrees to ensure that all materials borrowed or loaned are returned promptly and in the same condition they were received. The organizer agrees to accept responsibility for damage or loss of materials borrowed or loaned from the hospital.
By checking this box I agree to the Community Event Guidelines listed above

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