Third-Party Form


    PROPOSED EVENT INFORMATION

    Please describe how revenue will be generated (i.e. admission fees, tickets, raffle, proceeds):

    Do you require any of the following (please check):

    Tax Receipts: YesNo
    *If you checked YES then you will need to speak with a representative in the Development Department at Covenant House Michigan to ensure that your event is eligible to issue tax receipts.

    Liquor License: YesNo

    Gaming License: YesNo

    Covenant House Michigan Staff Assistance: YesNo

    Please note: For some events and activities it is necessary to take out a liquor or gaming license. However, Covenant House Michigan will NOT take out a liquor or gaming license on behalf of a third-party event.


    BUDGET

    EVENT BUDGET PROJECT AMOUNT ACTUAL AMOUNT
    Total Revenue
    Total Cost (fill out below)
    Venue $ $
    Printing $ $
    Prizes $ $
    Food/Beverage $ $
    Advertising $ $
    Other (specify) $ $
    Total Revenue-Total Cost=

    I, understand Covenant House Michigan reserves the right to approve or deny
    this proposal to host a third-party event on behalf of Covenant House Michigan. Pending approval, I
    agree the Covenant House Michigan name and logo are registered trademarks and I will follow the
    guidelines set for their usage prior to publicizing or holding this event. I agree that a representative of
    Covenant House Michigan must approve this proposal and the use of the event’s name prior to the
    event. By publicly naming Covenant House Michigan as the beneficiary of my event, I agree to donate
    the full amount of the proceeds raised within 60 days of the event date


    For Covenant House Michigan Use ONLY
    Date Approved: ______/______/______
    Approved by: _______________________

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