Fundraising Card Request Form

Ashland

Please fill out this form to request Fundraising Punch Cards from Malibu Jack's. Fundraising Punch Cards are for non-profits only. Completing the form does not mean you'll receive the cards. If selected to receive fundraising cards, 30 days may be required to process the order. A valid credit card on the pickup date is required to receive the cards.

Malibu Jack's Facility:*
Name of Requester:*
Email:*
Phone Number:*

(123) 456 - 7890

Organization:*
Organization EIN:*

Ex: 12-1234567

Desired Pickup Date*

(Malibu Jack's may require 30 days to process request)

How many Fundraising Cards do you need?*

Ex: 100 (Minimum 50)

Approximate number of people selling the cards?*

Ex: 20

Additional Comments: