USBRS Fundraiser Questionnaire 2012 Survey

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1. Please give us your name and current address:

Please give us your name and current address: Name
Company
Address 1
Address 2
City
State
Zip
Email Address

2. Do you want to recieve our core supporter updates during the campaign and wrap up?

Do you want to recieve our core supporter updates during the campaign and wrap up? Yes

No

If yes, please give your email if not listed above.

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3. Are you a member of Adventure Cycling?

Are you a member of Adventure Cycling? Yes, I am a current member

No, but I have been in the past

No, I have never been a member

I'm not sure

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4. We encourage you to set a fundraising goal of at least $100 (asking 10 friends or family members for $10). You can commit to a lower amount if that feels more feasible to you. Please tell us what your fundraising goal will be for this campaign. We have included the thank you gifts below that you will receive for reaching the various goals.

We encourage you to set a fundraising goal of at least $100 (asking 10 friends or family members for $10). You can commit to a lower amount if that feels more feasible to you. Please tell us what your fundraising goal will be for this campaign. We have included the thank you gifts below that you will receive for reaching the various goals. $50-$99 - a set of 3 CO2 Cartridges

$100-$249 - a custom USBRS Walz Cycling Cap

$250-$999 - an Agent X1 Multi-tool

$1,000-$2,499 - a Jersey of your choice from our Cyclosource Catalog

$2500+ - a Life Membership with Adventure Cycling

Other, please specify

Thanks for agreeing to help out! We will be using an online fundraising platform called Razoo this year. You will find information on setting up your fundraising page after you hit "submit". For more questions you can always visit our core supporter help page: www.adventurecycling.org/coresupporter