The following information must be completed in order to process and schedule your fundraiser. Once your request is submitted you will receive a confirmation e-mail with additional details.

Fields marked with * are required.
FUNDRAISER INFORMATION
* Today's Date:
* Benefiting What Group or Team?:   (Example: South Lake High School PTA)
* Approximate Number of Members in Your Organization:
* Isaac's Location for Fundraiser:	-- Choose Location -- Centerville Downtown Lancaster Ephrata Exton Granite Run Greenfield Harrisburg/Linglestown Rd. Harrisburg/Paxton St. (Near Bass Pro) Hershey Lemoyne/West Shore Plaza Lititz Mechanicsburg/Rossmoyne Bus. Ctr. Mechanicsburg/Silver Spring Commons Mt. Joy Reading Strasburg Thornbury East York (near Galleria Mall) South York (In South York Plaza) West York Hanover Not Applicable
Greenfield not accepting fundraisers between March 12th - 29th.
* Date for your Fundraiser:    Fundraisers must be set at least 4 weeks in    advance, Sunday-Thursday, 5pm-9pm.    Click Here to see available dates on our    Fundraising Calendar.	1st Choice  Click the calendar icon to choose your date ^
	2nd Choice
ORGANIZATION INFORMATION
* Organization Name:
* Official Address of Organization:
* City:
* State:
* Zip:
Click if mailing address is the same as the address above.
* Mailing Name:
* Mailing Address for Check:
* City:
* State:
* Zip:
* Contact Name:
* Daytime Phone Number:
* Contact Email Address:
* How did you hear about our Program?:	Employee
If employee, please provide name:
	Friend
	Website
	Flamingo Fan Club
	Promotional Materials in Restaurant
	Hosted Previous Fundraiser
	Postcard
If postcard, employee name on card:
	Other
If other, please describe:
* Is your organization a non-profit    organization as defined and recognized    by the IRS?:	Yes No
Note: For organizations that do not qualify as a 501(c)3 organization, as recognized    by the IRS, we may require a W-9 form to be completed.
Is there anything else you'd like to share with us about your request?:
If you are experiencing any difficulties completing this form or have any questions, please contact Debra Miller, Community Care Coordinator, at or 717-394-0623, ext. 22.