Third Party Event / Initiative Application
Thank you for your interest in supporting our charity, MY HOPE CHEST.
Please review our Guidelines for Special Events, Benefits or Promotions
prior to completing this application.
Please Note:
 Applications should be submitted at least 30 days prior to event/initiative.
 All applications will be reviewed by our Events Committee with notification of our
decision within approximately 10 business days after receipt of application.
 MY HOPE CHEST requests a minimum guaranteed donation of $1,000.00*
for all ONE DAY third-party events/initiatives. **Corporate partherships and ongoing
product related initiatives require a separate Application.
 Please contact Alisa Savoretti @ (727) 642-4243 with any questions.
Contact Information
Applicants Name:
Business, Organization or Group Name:
Street Address:
City:
State:
Zip:
Country
Event Information:
Brief Description of Event:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Date__________________ Time: _____________________
Location: __________________________________________
List any Sponsors or Underwriters: (If Applicable) __________________________________
Please list other Charitable Organizations that will benefit from this Event: (If Applicable)
___________________________________________________________________
Budget Information
Projected Gross Income From Event
Projected Expenses
Projected Net Revenue
Projected Donation to MY HOPE CHEST
(Specific percentage of net revenue or specific dollar amount
to be contributed must be stated)
$
$
$
$
You may submit the application via email to info@myhopechest.org.
Direct questions to (727) 488-0320, Mail to My Hope Chest, P.O. Box 3081, Seminole, FL 33775
2013 ~ MY HOPE CHEST all rights reserved
BUTTERFLY TEAM FUNDRAISING GUIDELINES
Thank you for your interest and enthusiasm in conducting a project to benefit the My Hope
Chest. Your efforts help us to accomplish our Mission.
My Hope Chest is the only national social service organization dedicated to helping
uninsured and under insured breast cancer survivors with breast reconstruction,
providing closure from the disease.
When conducting a project for the My Hope Chest please adhere to the following guidelines. It
is the responsibility of the Butterfly Team Leader to share this information with all team
members.
1. When holding a fundraiser where expenses are incurred, teams must plan for the following:
 How will expenses be paid and where will funds for these expenses come from?
 Is the revenue worth the effort of volunteer time?
2. Any expenses incurred during a team fundraiser are the sole responsibility of the
individuals contracting for the goods and services.
3. All checks made payable to the My Hope Chest can only be deposited into an authorized
“deposit only” account, and expenses cannot be reimbursed under any circumstances
through this account.
4. No bank accounts can be opened under the My Hope Chest name.
5. If your team fundraiser is conducted and promoted in support of My Hope Chest, all
proceeds must go to My Hope Chest. The sponsor or any individuals involved with the event
may take no fees, commissions or salary.
6. Hope Float’s Butterfly fundraising teams are not allowed to use the My Hope Chest Florida
State Sales Tax-Exempt or Federal Employer Identification numbers when directly purchasing
materials or supplies for their fundraisers from suppliers/vendors. Both Florida and Federal tax
laws specify that groups raising funds independently to later provide financial support to My
Hope Chest are prohibited from claiming exemption from State and any other applicable taxes
on such purchases.
7. Permission to use the My Hope Chest name and/or logo on any promotional materials (print
or broadcast), are granted ONLY when a 3rd Party Event Agreement is filled out and on file
with My Hope Chest.
Appropriate wording for any promotion of the charity is as follows:
“_________(Specify amount either dollar or %) of the proceeds raised from (“Hope Floats” or
event name) will go to benefit the My Hope Chest’s breast reconstruction program and
services.”
SPONSORS: Should your event procure sponsorship, the sponsor of the event must
consider any expenses incurred in production of the event as a “donation.” If the
sponsor wishes to take expenses out of the proceeds of the event, checks MAY NOT be
made payable to the My Hope Chest and will not be tax deductible.
8. The My Hope Chest name and logo may not be used in any way that may appear as a
trademark or endorsement of the sponsor’s product(s).
9. My Hope Chest will provide acknowledgement letters for items donated to the event.
However, you must be responsible for forwarding the donor’s name, address, phone number,
and the description of the gift to the My Hope Chest within two weeks after your project. The
acknowledgement letter from the My Hope Chest will state the description, not the value, of
the donated item.
10. My Hope Chest reserves the right to request you not approach a particular donor,
business or organization for the purpose of underwriting or contributing to your project due to
potential conflicts of interest that may arise among other income development initiatives and
your plans.
11. My Hope Chest cannot be responsible for insurance coverage liability or liquor licensing
for any outside sponsored event. This will be the responsibility of the sponsor. (As required by
the insurance carrier of My Hope Chest due to the fact that My Hope Chest does not have
control of the activities in the outside sponsored event).
12. My Hope Chest is a public charity that cannot support or oppose political candidates or
parties. My Hope Chest can invite current legislators to attend MHC-sponsored fundraising
events. However, you should emphasize to the legislator in writing that MHC is a non-profit,
charitable organization that may not engage in political activity and request that they refrain
from doing any campaigning at the event. Violation of this prohibition can result in revocation of
MHC’ tax-exempt status. Giving a specific candidate complimentary passes to an event that
others must pay to attend is prohibited.
13. My Hope Chest reserves the right to refuse involvement in your project at will. Additionally,
My Hope Chest reserves the right to terminate partnership with your business/organization
and/or you at will.
14. My Hope Chest requests that teams carefully consider their fund raising efforts. During the
planning of any event ask these questions:
 Is it ethical?
 Is it offensive to any group?
 What is the financial risk/outcome?
 Do we have unanswered questions or any doubt? Call your local American Cancer Society
office.
My Hope Chest truly appreciates the hard work and effort put into raising dollars for our
mission! We must all work to preserve the integrity and reputation of My Hope Chest to
continue to help every breast cancer survivor heal in body, mind and spirit after cancer.
Thank you and your Butterfly Team!
PRESS RELEASE:
HOPE FLOATS on BRA DAY for My Hope Chest at
__________________________________________________________________
On October 16th 2013 (our during the week of, or month of October), ______________________
(facility, individual or corporation) is holding its “1st (or 2nd) Annual “Hope Floats on BRA DAY”
fundraiser for charity in support of My Hope Chest, the only national 501c3 non-profit funding
reconstruction for uninsured and underinsured survivors. The event will be held at
___________________________. (Location, Date and Time)
“Breast Reconstruction Awareness Day, aka BRA Day” was first declared in the United States in
October of 2012 by the American Society of Plastic Surgeons (ASPS.) The annual event held on the 3rd
Wednesday of the month in October, was created originally in Canada to highlight the lack of education of
breast reconstruction options at point of diagnosis for breast cancer patients and survivors.
________________________ (facility, individual or corporation) supports My Hope Chest mission is to
Create Butterflies and transform lives, restoring a breast cancer survivor in body, mind and spirit.
“____________________” (Insert Quote by organizers of event about why they support MHC and its
mission)
About My Hope Chest
More than 22,000 uninsured women a year lose their breast and lack means to acquire breast reconstruction
surgery. My Hope Chest has a wait list nation wide, with referrals coming from the largest breast cancer
organizations in America. All individuals, medical professionals and breast cancer survivors are
encouraged to attend “Hope Floats” and support the unique mission this October.
Contact _____________________ for tickets or more information about participation. Visit
www.myhopechest.org for more information on their services and to make a donation.
October 16th 2013 is
“Breast Reconstruction
Awareness Day!”
(Host- Individual breast center, caregiver, company) ________________ has signed up
our “Butterfly Team” to support My Hope Chest this October … A breast cancer
organization with a unique mission dedicated to Creating Butterflies and changing lives!
DATE (During October or on Oct 16th) ______________ (host) will (Explain the Fun-Raiser)
______________________________________________________________________________________
__________________________________________________________________
CHARITY MISSION
My Hope Chest is the only national 501c3 organization providing breast reconstruction to
uninsured and under insured survivors. Their services pick up where other breast cancer organizations
leave off, providing the “final step of breast cancer treatment”
In 2012 “Breast Reconstruction Awareness Day” was designated in the USA, by
the American Society of Plastic Surgeons to address education of breast
reconstruction options at point of diagnosis for breast cancer patients.
(Host) ____ is proud to RALLY support for My Hope Chest on
this significant new day of Hope for survivors… with our
First Annual “Hope Floats” Fun-raiser! Support our
BUTTERFLY TEAM and learn more about My Hope Chest!
CONTACT: (Employee@) ________
SAVE THE DATE!!!
WHAT
WHEN
WHERE
FUN~Raiser!
A Charity event benefiting
My Hope Chest and
breast reconstruction.
During October or Oct 16, 2013
TiIME?
Lunchtime 11:30 – 1:00
After work or at Sunset 6:30 – 8:30
Address:
Your Office,
A favorite restaurant, card group,
civic club, at the beach or park!
Just when the caterpillar thought her world was over… she became a butterfly.
DOANTE to our “BUTTERFLY TEAM’S” VIRTUAL CAMPAIGN at……….. www.myhopechest.org/HF