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ONLINE APPLICATION
Organize a Fundraiser for Hudson Valley Cancer
First name *
Last name *
Email address *
HOME ADDRESS*
CITY
STATE
ZIP
PHONE
If you are completing this form on behalf of a group or organization, please include the group’s name below.
If available, please provide a link to the primary social media site or website for the organizing group or fundraiser.
Have you hosted an event for Hudson Valley Cancer before?*
Yes
No
Please tell us about your relationship with Hudson Valley Cancer*
Please provide a brief description of your fundraiser*
FUNDRAISER NAME*
FUNDRAISER LOCATION*
FUNDRAISER START DATE*
FUNDRAISER END DATE*
FUNDRAISING GOAL*
Why did you choose HVC as the beneficiary of your fundraiser?*
If there are beneficiaries of your fundraiser in addition to HVC, please list them below
SUBMIT APPLICATION