Organization: (Do not use acronyms)

Group Leader: E-mail: Phone:

Treasurer: E-mail: Phone:  (Must be different from the group leader)

Have you reviewed the terms and conditions? Yes No
What will the funds be used for?:

Number of Participants:
Number of Catalogs Requested:
Begin Sale Date:
End Sale Date:
(Please contact us if the turn in date changes during your sale)

Mail the catalogs to this address...
Address:
City:
State:
Zip:

Ship the candles to this address...
Address:
City:
State:
Zip:
Is this a residence? Yes No

How did you hear of us? -- Please select -- Google Referral Word of mouth Prior Customer Facebook Email Other