Fall 2017 Campaign Event Attendance Question Title * 1. Please provide the below information: Organization Name: Your Name and Title: Your Phone Number: Your Email Address: Campaign Events Question Title * 2. Are you interested in receiving invitations for: Charity Fairs Speaking Engagements Both None Question Title * 3. Will you be our main contact for events? Yes Yes but I would like have others be contacted as well No, someone else will be the contact for events Contact Information (Name and Email) for Other Event Reps, if Applicable Question Title * 4. Please select areas where you would like to focus your event attendance. If you would like to receive notifications for all events across the United States, please select the first option and continue to Question 5.By not checking a state/region, you are opting out of events in that area unless a charity event requests your organization by name. At that point, we will reach out to you with the event information. Nationwide - I am interested in receiving notifications for ALL events None - I am opting out of all events Alabama - Montgomery Alabama - Birmingham Alaska Arizona - Phoenix Arizona - Tucson Arkansas - Little Rock Arkansas - Fayetteville California - Northern (San Francisco, Sacramento, Fresno) California - Southern (Los Angeles, San Diego, Santa Barbara) Colorado - Denver/Boulder Colorado - Colorado Springs Connecticut Delaware District of Columbia - Washington, D.C. Metropolitan Region (DMV) Florida - Eastern and Northern (Orlando, Jacksonville, Tallahassee, Gainesville) Florida - Southern (Miami, Tampa, Naples) Georgia - Northern and Eastern (Atlanta, Augusta, Savannah) Georgia - Southern and Western (Columbus, Brunswick, Albany) Hawaii Idaho - Boise, Idaho Falls Idaho - Lewiston Illinois - Chicago Illinois - Springfield, Peoria Indiana Iowa - Des Moines Iowa - Davenport, Cedar Rapids Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri - St. Louis, Kansas City, Jefferson City Missouri - Springfield, Joplin Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York - NYC/Long Island New York - Upstate (Binghamton, Buffalo, Rochester) New York - Albany North Carolina North Dakota Ohio - Columbus, Cleveland, Toledo Ohio - Southwest (Cincinnati, Dayton) Oklahoma Oregon Pennsylvania - Eastern (Philadelphia, Harrisburg, Scranton, Lancaster) Pennsylvania - Western (Pittsburgh, State College, Gettysburg) Rhode Island South Carolina South Dakota - Sioux Falls South Dakota - Pierre, Rapid City Tennessee Texas - Northern (Dallas, Midland, Abilene) Texas - Gulf Coast (College Station, Houston, Corpus Christi) Texas - Central (Austin, San Antonio) Texas - Western (El Paso, Lubbock) Texas - Panhandle (Amarillo) Utah Vermont Virginia - Northern (Fairfax, Vienna, Winchester) Virginia - Southern (Richmond, Roanoke, Virginia Beach) Washington West Virginia Wisconsin Wyoming Promotional Items Question Title * 5. Do you plan to send America's Charities any of the following to use at various campaign events? Yes: Giveaways/Promotional Items Yes: Brochures Yes: Both Giveaways/Promotional Items and Brochures No Chapters/Affiliates Question Title * 6. Does your organization have a network of chapters, affiliates, or remote staff? Yes No Please provide explanation, if desired. Question Title * 7. Do you plan to have employees of chapters/affiliates, remote staff, or volunteers attend events on behalf of your organization? Yes No Please provide explanation, if desired. Question Title * 8. If yes to Question 7, may we send event invitations to your chapters/affiliates or remote staff directly? It's okay to contact my chapters/affiliates directly. Please do not contact my chapters/affiliates. It's okay to contact my chapters/affiliates, but please check with me each time before sending them notifications. Not Applicable Please provide explanation, if desired. If you would like us to send event invitations to your chapters/affiliates or remote staff, please send a spreadsheet to EBernhards@charities.org with information for individuals who we should contact (Name, Email, Phone Number and States/Regions Covered). Question Title * 9. Would you like us to include your chapters/affiliates in private sector campaigns, where we are able? Yes No Not Applicable If yes to Question 9, please send a spreadsheet to EBernhards@charities.org with the following information for all chapters/affiliates that fall under your parent organization: Affiliate Name, Affiliate EIN, Affiliate Physical Address, Affiliate Phone Number, Staff Contact Name(s) & Title(s), Staff Contact Email Address(es). Done