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No shriner, club, unit, or organization of Nobles shall engage in any fund-raising activity whether it be for
Charitable or Fraternal purposes without first obtaining written consent of the Potentate. Please submit this
form before the event, with rough drafts of the publicity articles, ticket designs, and disclaimer statements, so
compliance with Imperial Council rules may be assured. Approval will be returned as soon as possible.
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THE REQUESTOR
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NOTE - First select from the "drop down" list directly below by clicking on the arrow button located at the right
end of the box then highlighting your Unit or Club by clicking on it. Then click on the small box to the right of the
Club/Unit box. This is to lock-in your club or unit. If you have a scrolling wheel on your mouse and do not lock
your club/unit selection, the Internet Browser thinks you are still selecting and will continue scrolling the
drop-down list.
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To Begin - Select Club or
Unit Then Press [TAB] Key
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Club or Unit:
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(If Not In List, Enter Here)
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Submitted By:
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Submitter's Phone #:
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THE ACTIVITY
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Sponsored By:
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(Enter Here If Other Than Above)
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Activity Location:
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Date:
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Time:
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Activity Type:
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(Parade, Off-Premise Clinic, Special Event, etc.)
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Planned Distribution Of Proceeds:
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Fraternal
Charitable
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THE APPROVAL
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An Approval Will Be Sent To You. How Would You Like It Delivered?
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SHRINE CENTER INTERNAL MAIL
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<<< Click Here To have The Approval Will Be
Placed In Your Mail Box At The Shrine Center
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FAX
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<<< Click Here then
Enter Fax Number
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EMAIL
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<<< Click Here then
Enter Email Address
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USPS MAIL
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<<< Click Here then
Enter USPS Address
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Check (Click On) This Box If You Want To Use The "SUBMITTED BY" Name
From Above, Leave "Mail To Name" Field Below Blank and Proceed To The
Address Fields
-OR- Do Not Check The Box and Enter A Different "Mail To Name" Below
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Mail To Name:
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Mail To Address Lines:
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NOTE: IMPERIAL LAW PROHIBITS CLUBS/UNITS OR MEMBERS ACCEPTING REWARDS
OR MONETARY COMPENSATION FOR PARTICIPATING IN PARADES OR EXHIBITIONS.
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