Request a Fundraiser with BRAKEmax

Organization Name*
Organization Website
Organization Mission*
501c3 Tax Exempt*
- Yes - Exempt
- No - Not Exempt
List any of the organization's social media profiles below:
Select the date of the fundraiser.*
MM slash DD slash YYYY
Select the deadline for receiving fundraising submissions.
MM slash DD slash YYYY
Please describe the type of fundraiser support requested:*
Please upload any relevant documents or files.
Max. file size: 1 MB.
Your Name*
First Last
Your Email*
Your Phone Number*
Were you referred to BRAKEmax for fundraising? If so, please list the referrer(s) below:
Consent*
I confirm.
By checking this box, I confirm that I have authority to act on the listed organization's behalf.
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