Printable Version of Fundraiser Form (Word)

4-H FUNDRAISER FORM

Completed form must be submitted to the Extension Office weeks prior to 4-H event/activity/fundraiser even for approval. 

Return form to: Fallon County Extension 
P.O. Box 850; 10 W Fallon Ave. Baker, MT 59313 
fallon2@montana.edu 

Person/Club/Group Making Request: _________________________________________________________________ 

Phone/Email: ______________________________________________________________________________________ 

Date of Fundraising Event: __________________________________________________________________________ 

Location of Fundraising Event: ______________________________________________________________________ 

Destination of Event Proceeds: ______ Club  ______Council  ______Other ______________________________________ 

Description of Fundraiser (include educational purpose, who will benefit, activity, fundraising) 

Proceeds will be used for: 

 

Permission and Release Forms will be needed for any non 4-H participants. (EX Open horse show Permission/Release 

 

Form must be signed for non 4-H participants.) Permission/Release Forms are available at the Extension Office. Person responsible must have form prior to event and it must be attached to this form after the event. 

Signature of Requestor: ___________________________________________________Date: _____________________ 

Extension Office Signature: _______________________________________________ Date: _____________________