Phone Applicant Information School Name New or Renewal New Renewal Fundraiser Administrator Name Email Cell JMS Representative Name Email Cell Shipping Address City State - Select Province/State - Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ==================== Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Phone Email Website Group Name Group Type Number of Students Age Elementary Middle School High School Contract Date Fundraiser Goal Fundraiser Start Date Fundraiser End Date Platforms Which Product? InstaRaise InstaRaise Rewards Race to the Top Sweepstakes MatchRaise Participation in PrizeBox? Yes No Product Fundraisers Which Product Fundraiser? Fusion Drinkware Poppin Popcorn Giveable Participation in PrizeBox? Yes No Contract Terms Contract Terms Campaign Material Provide 4-6 sentences about school/program: Please attach: Jpeg Logo Two JPEG pictures for website Click to add second image Youtube Link (if applicable) For MatchRaise Campaign: See Fund Matchers form for additional info needed Agreement and Signature JMS Will Provide Fundraiser material. Including associated campaign material to assist in executing a successful campaign. Fundraiser main website with admin dashboard and unlimited student pages and dashboards. Fundraising assistance for those in your organization who will be spearheading this campaign (includes involvement throughout the campaign). PrizeBox incentive program consisting of large selection of up to date prizes worth 3-4 times the amount set aside by program. PrizeBox is offered to schools setting aside 5% of funds raised to be used to incentivize students. Profit check to mailed to school/program within 2 weeks of fundraiser closeout. All sales/fundraising data accessible by sponsor and per student after fundraiser closeout and availabe in dashboard for subsequent fundraisers. Rules and Regulation for Sweepstakes: All donations solicited in person will be collected by program director and deducted from periodic funds distributed to school. Applicable percentage of donations solicited online will be distributed to school at end of campaign or for campaigns longer than one month every 4 weeks throughout campaign with remainder paid at end of campaign. Each ticket must be sold for fixed prices of the campaign. Absolutely no giving away free tickets as an incentive or selling tickets for any price other than those listed on material. Every aspect of rules and regulations must be followed strictly. All design work done by JMS will include all legal wording necessary. None of the text may be changed. All design work done by partnering organizations must be approved by JMS to make sure that they fully comply with campaign legalities. Name Title Date Consent I have read the above and will abide by all rules and regulation, and legal guidelines.