Maximize Life Campaign Packet
Instructions:
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Complete the Event Proposal Form if your organization would like to participate in the
campaign by hosting an event
Eligible groups who wish to also apply for a grant must complete the 2016 Maximize Life
Campaign Budget Form and Budget Worksheet
Send completed forms to The Max Foundation representative in your area or directly to
The Max Foundation at [email protected].
Deadline for proposal submissions is June 27, 2016. Awards will be announced by
August 1, 2016.
2016 Maximize Life Campaign Overview
Calling all advocates and partners of the Max Global Network! We invite you to join us in
celebrating those who have overcome adversity and encouraging them to share their story with
others by participating in the 2016 Maximize Life Campaign!
Partner organizations of the Max Global Network are encouraged to host events during the
month of October 2016 that provide a platform for sharing cancer stories and that feature at
least one inspirational speaker who has been impacted by cancer. Partner organizations that
require funding for their events are encourage to apply for a campaign grant. In an effort to
create positive change for people living with cancer in our communities, Maximize Life
Campaign events should aim to:
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decrease the feeling of isolation and increase hope for survivors and caregivers who
participate in campaign events
increase local community awareness and support for people living with cancer
Maximo and the Big C books will be available as resource for organizations. Read more about
Maximo and the Big C.
Partner organizations would like to participate by hosting an event for the 2016 Maximize Life
Campaign must complete the campaign proposal form in this packet. Partners who are
registered in their home countries and who require financial assistance for their event may apply
for a grant of up to US$1000. Nonregistered patient associations may apply for a Community
Leader Grant of up to US$500 through an individual in their organization. These grants are to be
used as seed money to conduct an event in your local community. Kindly note that receiving a
campaign grant is not a requirement for campaign participation and any partner hosting an
event must complete the Event Proposal Form to be included as a campaign partner, regardless
of whether a grant request is made. For more information, please read the grant FAQ or contact
your local Max representative.
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Event Proposal Form
****Submission deadline June 27, 2016 to The Max Foundation
Organization name:
Click here to enter text.
Organization city/country:
Click here to enter text.
Organization website:
Click here to enter text.
Contact person:
Click here to enter text.
Contact phone number:
Click here to enter text.
Contact email:
Click here to enter text.
Event(s) name:
Click here to enter text.
Event(s) date:
Click here to enter text.
Event location(s):
Click here to enter text.
Please provide a detailed description of your proposed event(s):
Click here to enter text.
Please explain how you propose to involve volunteers in your event(s):
Click here to enter text.
Please describe how you plan to feature cancer survivors as speakers in you event(s):
Click here to enter text.
Please pledge the number of individuals that will directly benefit from your event(s).
☐ 50+
☐100+
☐200+
☐500+
Other:___________________
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Please pledge the number of volunteers that will be engaged in your event(s).
☐10+
☐20+
☐30+
☐40+
Other:___________________
If your group is interested in receiving copies of Maximo and the Big C from The Max
Foundation, in the section below please explain how they would be used during the
event(s) and mark the number of copies you wish to receive:
☐ 60 copies of Maximo and the Big C
☐ 120 copies of Maximo and the Big C
Click here to enter text.
If you are requesting in-kind donations, please note that while The Max Foundation will
pay for shipping; your organization will be responsible for customs duties and
logistics.
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Budget Worksheet
Organization Name and Country: Click here to enter text.
Phone: Click here to enter text.
Email address: Click here to enter text.
Is your patient group registered in your home country and able to receive funds?
☐ YES ☐NO
If you selected “NO” you are eligible to receive a Community Leader Grant of up to US$500, but
are not eligible for the US$1000 grant.
(This form is ONLY required for groups requesting monetary grants)
Budget Worksheet
Items
Expense (USD)
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Materials & Supplies
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Rental Fees
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Food & Beverage
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Miscellaneous
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BUDGET TOTAL (USD)
Total Budget Requested
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$Click here to enter text.
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