Please fill out the Third Party Event Application form and a HelpCureHD staff will contact you within 72 hours of your submission.

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

How did you hear about us?

Tell us about your fundraiser?

Location of fundraiser?

Date and time of fundraiser?

Fundraising goal?

Have you reviewed the HelpCureHD Third Party Resource Guide

if no, please read the guide before proceeding