Autism Society NWPA | Third-Party Event Application

Name(Required)

Phone(Required)

Email(Required)

Enter Email Confirm Email

Name of Company/Organization, if applicable

Address(Required)

Event Coordinator Name (if difference from above)

Event Coordinator Phone

Event Coordinator Email

Enter Email Confirm Email

Name of Event(Required)

Date of Event(Required)

Event Starts(Required)

:

Event Ends(Required)

:

Decription of Event(Required)

Location of Event(Required)

Is the event?(Required)

Open to the Public

By invitation

Is there an admission cost for the event? (Ticket Cost)(Required)

Is this, or will this be, an annual event benefiting the Autism Society NWPA?(Required)

Yes

No

To be determined

Do you plan to use the Autism Society NWPA's name and logo in promoting the event?(Required)

Yes

No

I/we understand the Autism Society NWPA’s name and/or logo cannot be used to promote a third-party event without prior approval by Autism Society NWPA’s Executive Director.

If yes, please decribe how the event will be publicized.(Required)

We have created an image to be used for this event. We understand approval from Autism Society NWPA is still required.

Accepted file types: jpg, jpeg, png, gif.

Estimate the number of anticipated attendees/participants(Required)

What are you estimating for the net proceeds from this event?(Required)

Describe how you plan on generating revenue at this event.(Required)

What percentage of your estimated net proceeds will be contributed to the Autism Society NWPA?

If less than 100%, what other organization(s) will share in the net proceeds?

Email

This field is for validation purposes and should be left unchanged.

THIRD-PARTY APPLICATION

Autism Society NWPA | Third-Party Event Application

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