Target House Special Event Application

Asterisk (*) indicates a required field.

Contact Information

Organization/Sponsor*

Contact Name*

Address 1*

Address 2

City*

State/Province/Region*

Zip/Postal Code*

Home Phone Number*

Fax Number

Cell Phone Number*

Email Address*

Previous Event Information

Have you done a special event at Target House in the past?*

If so, what was the event?

If so, who was your contact?

Date of previous event

Current Event Information

Does your group have a relationship with a current or former St. Jude patient?*

Yes No

If yes, please describe relationship

Type of Event*

Cleaning and Organizing (maximum number of volunteers: 10) Crafts and Games (maximum number of volunteers: 10) Movie Night (maximum number of volunteers: 7) Provide a Meal (maximum number of volunteers: 15) Scavenger Hunt (maximum number of volunteers: 15) Other (maximum number of volunteers: 10)

Number of people in group*Maximum group size is 15

Event name and description*(please be as specific as possible and include details on any crafts or activities you plan to provide)

Supplies provided by group*(group is expected to provide all materials necessary for event)

Please list any giveaways you plan to provide(giveaways are not expected or appropriate for all events, but must be approved in advance in order to be distributed to families)

Dates you would like to host the event

First choice date*

Second choice date*

Time of program?*

Morning (9 am 'til noon) Afternoon (noon 'til 4 pm) Evening (4 pm 'til 8 pm)

Set-up time required?*

No set-up 10 minutes 15 minutes 20 minutes

Breakdown time required?*

No breakdown 10 minutes 15 minutes 20 minutes

Submission

I have read and understand the Target House Requirements for sponsoring special events.

Initials*

Date*

I agree to share this information with St. Jude*
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