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Distributor / Organization Brochure Fundraising Agreement

Most fields below are required to properly process your request. Please complete the form below to sign up.

Organization / School Name:

* (required)

Address:

* (required)

Address line 2:

(if needed)

City:

* (required)

State:

* (required)

Zip:

* (required)

Shipping Address (if different)

	First name	Last name	Alt. Contact
Sponsor Name:
*Must be at least 21 years old (required)

Title of Sponsor:

Day Phone

- - Ext:
* (required) (no dashes please)

Evening Phone

- -

FAX:

- -

Email:

* (required)

Number of Participants:

* (required)

Tax ID Number or Resale:

(if applicable)

Please Select Your Brochure:

Date you require brochures / etc. delivered:


Month	Day	Year
* (required)	* (required)	* (required)

Start Date of Drive:


Month	Day	Year
* (required)	* (required)	* (required)

End Date of Drive:


Month	Day	Year
* (required)	* (required)	* (required)

The Organization has an option of receiving prizes for participants or a 2% rebate off the invoiced amount, please select your option:

	Prize Program
	2% Discount on your order

How did you hear about our company?

Rebate Code:

(if applicable)

Rep Account #

(if applicable)

Additional Comments :

This Agreement, made on this DATE: 05/13/08 , by and between Tracy Hamilton Inc. ("Distributor") also doing business under the name Fundraisingzone.com, and ("Organization")
Distributor and Organization hereby agree to the following:

The above listed Organization will abide by the terms and conditions contained within this agreement and are hereby agreed upon by Tracy Hamilton Inc, the Organization and the undersigned sponsor of this agreement.
	« *I agree to the terms listed above. (required)**
	« Your Initials * (required)

Tracy Hamilton, Inc. reserves the right to except or reject any and all Brochure Fundraising agreements submitted.

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