Fundraising Event Submission

Thank you for your interest in hosting an event to support Mary Bird Perkins Cancer Center or Cancer Services. Please tell us about your event and we will be in contact soon.

Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email Address*
Event Name*
Select the center you are fundraising for*
Event Location*
Event Date*
Date Format: MM slash DD slash YYYY
Event Time*

: HH

MM
Event Description*
Fundraising Goal*
Fundraising URL*
Examples: Facebook Page, Facebook Event Page, Website URL, etc. Put N/A if not applicable.
Any other comments (optional)
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1-800-489-7800

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