Fundraising Request Form2018-08-06T12:06:01+00:00

Application for Special Event, Benefit, or Promotion

Please submit your application for consideration no later than 4 weeks prior to your event.
  • Date Format: MM slash DD slash YYYY
  • (All proposed materials utilizing Susan G Komen Miami/Ft. Lauderdale Affiliate logo must be pre-approved prior to use) Applicant understands that approval must be granted by Komen and a Letter of Agreement must be executed by the parties before applicant can promote the proposed event. The Miami / Ft. Affiliate of Susan G Komen shall not be liable to any vendor or other third party for any fees, costs, or payments of any kind associated with the event, and applicant agrees to indemnify and hold harmless the Komen Miami/Ft. Lauderdale Affiliate against any such claims by third parties or vendors for said fees, costs, or payments.
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