DignityNet Express request form

Fundraising made easy!

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A great fundraiser for

schools or ministries

To start your fundraiser with DignityNet Express
please supply the following information.

Official Organization/School Name: (checks can be received in this name)
Type of Organization:
Address - Street Name & Number or Post Office Box:
Address - City, State, Zip:
Phone Number (including area code):
Contact Person:
Contact Person's Title:
Contact Person's Email:
Approximate number of contributors:
Please provide any instructions for receiving monthly commission checks:
I am authorized to make this request on behalf of my organization. The information provided in this form is accurate and true. Sign with your typed signature:

Your Express Button will be sent to your
email address after you submit this form.

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