Participant Application - Casa Prescott Valley

Sponsor and/or Participant Table Application

We are very excited for our Simply Seniors FREE Fun Fest on Wednesday, September 25. We encourage you to be a sponsor and/or table participant. It is always lots of fun and your agency will receive another avenue for exposure. Limited number of spaces are available! FREE LUNCH (11:30-12:30 pm)

All funds raised will assist in providing more than 31,000 in-house and Happy Meals-on-Wheels (annually) for area seniors. We need to raise more than $45,000 this year to subsidize our Senior Nutrition Program!

CASA Member-Volunteer-Donation App/Renewal (Annual)

Sponsor & Participant Table Application

Name of Agency

Agency Phone

# of Lunches Needed

Agency Address

City

State/Province

Zip/Postal

Contact Person

First

Last

Contact Phone

Fees

Sponsor Fee $350 (includes table fee)

Participant Table Fee $150

Payments

Date PaidDate Paid

Amount PaidAmount Paid

Payment MethodPayment Method

If you are human, leave this field blank.

Please note: Completing this form will help us serve you better, plus help us continue to qualify for funding so we can maintain our meal and vital services at as low cost to you as possible. This information will be kept confidential. Thank you.