STEPS Coordinator Application

Please fill out this form and return it to DSF to obtain approval for your DSF Steps Toward a Cure
event. Promotion and solicitation for your event is prohibited until approval of event has been given. Questions? Email misty@dravetfoundation.org

Name(Required)
Address
Have you been convicted of a felony or misdemeanor?
Is this your first time coordinating a fundraising event?
Is this your first time coordinating a fundraising event for DSF?

Site/Venue Information

Address
MM slash DD slash YYYY
Registration Start Time
:
Event Start Time
:
Does the venue require a Certificate of Insurance?
Are restrooms available onsite?
Is there a shelter in case of inclement weather?
Is there ample free parking?
Is the walk area paved/smooth for wheelchairs and strollers?
Are dogs on a leash permitted?
Are you responsible for trash removal?

Raffle/Silent Auction Information:

Will your event have a silent auction?
Will your event have a raffle?
Does your city/state require a permit for the silent auction or raffle?
Have you confirmed the venue permits a silent auction or raffle?

Event Details

What time does your event start?
:
What time will your event end?
:
BY SIGNING AND SUBMITTING THIS FORM YOU ARE ACKNOWLEDGING THAT ALL OF THE INFORMATION PRESENTED IS ACCURATE AND NOT FRAUDULENTLY REPORTED.

The information collected by Dravet Syndrome The information collected by Dravet Syndrome Foundation will not be sold or distributed outside of DSF and is used solely to verify identity and assist with communication. Questions or concerns can be directed to our team. 

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