Username*

Username*

Email*

Email*

First Name

First Name

Last Name

Last Name

Store Name*

Store Name*

https://goodtroublegourmet.com/fundraiser/[your_store]

Address 1*

Address 1*

Address 2

Address 2

Country*

Country*-Select a location-United States (US)

City/Town

City/Town

State/County

State/County

Postcode/Zip*

Postcode/Zip*

Store Phone*

Store Phone*

Hosting Organization*

Hosting Organization*

Are you an authorized representative of the Hosting Organization?*

Are you an authorized representative of the Hosting Organization?*Yes No

Authorization

Authorization

About the Organization (Group Only)

About the Organization (Group Only)

Logo

Logo

Banner (Static or Video) Group Only

Banner (Static or Video) Group Only

Purpose Statement

Purpose Statement

Fundraising Program*

Fundraising Program*Group Individual

Preferred Start Date (Group Only)

Preferred Start Date (Group Only)

Days to Fundraise

Days to Fundraise

Fundraising Goal*

Fundraising Goal*

Estimated Active Sellers (Group Only)*

Estimated Active Sellers (Group Only)*

About You (Individual Seller Only)

About You (Individual Seller Only)

Affiliate Photo (Individual Seller Only)

Affiliate Photo (Individual Seller Only)

Email*

Email*

Contact #*

Contact #*

Referred By

Referred By

Password*

Password*

Confirm Password*

Confirm Password*

* Agree  Terms & Conditions