Fundraiser Application

NOTE: It appears your browser does not support scripting (javascript).

Scripting is required to use this site. Please ensure scripting is enabled in your browser before continuing. If you have questions about enabling scripting on your browser please contact customer support at MyQuickResponse.

https

Search

Browse

SUPER VALUE CARD
Only $189.99
On SALE for only $149.99
On-line Special!

Midas Touch Oil Change
Midas Touch Oil Change

Employment Opportunities

Fundraiser Application

Join the Midas Oil Club

Schedule an Appointment

Tell Us about Your Last Visit

	Fundraiser Application
	Please fill out the following application and submit for approval: (For more information call the Midas Fundraiser Hotline at 728-1060)

Name of Organization

Date Organized

Number of Members

How did you hear about our Fundraising Program?

	Sale Period (Normally 60 Days)

Start Date

End Date

	Number of Tickets Requested

Tickets Requested

	100
	200
	300
	400
	500

	Financially Responsible Representative

Name

Home Address

City

Zip Code

Place of Employment

Business Phone

Home Phone

E-mail Address

Preferred Contact Method

Additional Comments: