Community Day Request

Please note that his form must be fully completed to be considered for a fundraiser evening.

A fundraiser is only considered scheduled once you receive confirmation of your date and participating location/s.
All requests must be submitted at least four weeks prior to the requested fundraising event date (six weeks preferred).
You will be contacted within two weeks of receiving your Fundraiser Request Form.

Contact Name
Organization Name (as you want it to appear on your flier) Max. 30 characters
Check will be mailed to:
Street Address:
City:	State  Select State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming  Zip
Phone (Include Area Code):
Location(s) Requested	Arcola	Bloomington on Eldorado	Bloomington on Parkway	Bourbonnais	Canton
Allow up to six locations.	Centralia	Champaign on Kirby	Champaign on Mattis	Charleston	Chillicothe
	Clinton	Danville on Bowman	Danville on Vermilion	Decatur on North Prospect	Decatur at South Shores
	East Peoria	El Paso	Fairbury	Gibson City	Gilman
	Hoopeston	Kankakee	Machesney Park	Mahomet	Manteno
	Mattoon	Momence	Monticello	Morton	Mt. Zion
	Normal	Olney	Paxton	Pekin	Peoria on Knoxville
	Peoria at Willow Knolls	Pontiac	Princeton	Rantoul	Robinson
	Shelbyville	Springfield	Sullivan	Tuscola	Tilton
	Tolono	Urbana	Villa Grove	Watseka	Washington
Community Day Date	Available Monday or Tuesday only.  Thirty days notice required.
	1st Choice
	Alternate Choice
Flier Color	Flier Color Light Blue Yellow Green Salmon Gold Pink Ultra Pink Ultra Orange Lime Green Orchid Lemon Red
Fliers mailed to nearest store.	Stores Bloomington on Eldorado 309-662-8502 Bloomington on Parkway 309-662-6933 Bourbonnais 815-932-9100 Champaign on Kirby 217-356-4243 Champaign on Mattis 217-359-3514 Charleston 217-348-7515 Danville on Bowman 217-443-3490 Danville on Vermilion 217-446-3111 Decatur South Shores 217-423-2333 Fairbury 815-692-4302 Gibson City 217-784-4623 Hoopeston 217-283-7781 Kankakee 815-928-8043 Mt. Zion 217-864-2060 Mahomet 217-586-4242 Manteno 815-468-7409 Mattoon 217-234-6442 Momence 815-472-3342 Monticello, IL 217-762-8484 Morton 309-284-0709 N. Decatur 217-875-7340 Normal 309-454-7999 Pekin 309-347-7761 Peoria on Knoxville 309-688-0747 Peoria on Willow Knolls 309-691-6477 Princeton 815-872-0090 Rantoul 217-893-1252 Springfield 217-546-7258 Sullivan 217-728-2373 Tilton 217-443-5545 Urbana 217-367-5781 Washington 309-444-7500
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