Fifty Second Sign up Form – Receive up to 50% Profits

Risk Free Brochure Fundraising Sign-up Form

*Required Fields

Organization Information
First Name: Required*
Last Name: Required*
Phone: * RequiredInvalid format.Ext:
Addl. Phone Invalid format.
Fax: Invalid format.
Email: RequiredInvalid format.*
Organization Name: Required*
Address: Required*
Address cont:
City: Required*
State: Please select an item.*
Zip: RequiredInvalid format.*
Sale Information
Number of Participants Please enter a number*
NYS clients please add tax ID #:
Please Select Your Brochure:
Online Only for Spring or Fall Gift Catalog?
Date Brochures Needed: RequiredInvalid format.*
Start Date of Drive: RequiredInvalid format.*
End Date of Drive: RequiredInvalid format.*
The Organization has an option of receiving prizes for
participants or a 2% rebate off the invoiced amount:
Prize Program
2% Discount on your order
* selection required
Additional Information
Additional Comments or Questions:

This Agreement, made on this DATE: Monday, January 17, 2022 15:22:45 EST, by and between Tracy Hamilton Inc. ("Distributor") also doing business under the name, 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.

Required I agree to the terms listed above. *
Required Your Initials *

Your privacy is of the utmost importance to our company, especially in these times of identity theft. Our company values the trust you have placed in us - we take it seriously. We will not rent, trade or in any way market your personal information to any third parties for the purpose of financial gain.