Fillable COVER-PRO APPLICATION FUNDRAISING CONSULTANT SUPPLEMENT r ual re (Philadelphia Insurance Companies)

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COVER-PRO APPLICATION FUNDRAISING CONSULTANT SUPPLEMENT r ual re (Philadelphia Insurance Companies)

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COVER-PRO
SM
APPLICATION
FUNDRAISING CONSULTANT SUPPLEMENT
1. Full name of the Applicant Firm:
2. What percentage of the Applicant’s g
r
oss ann
ual re
venue comes from the following fundraising activities?
% Political
% Charity
% Consulting
% Training
% Other: (specify)
% Other: (specify)
% Other: (specify)
100 % TOTAL MUST EQUAL 100%
ADD
ITIONAL INFORMATION
This section may be used to provide additional information to
any question on this ap
plication. Please
identify the question number to which you are referring.
I understand that the information submitted herein becomes a part of my Philadelphia Insurance
Companie
s Cover-Pro
sm
application and is subject to the same conditions as stated on the application.
Name (Please Print) Title (Must be Principal, Partner or O
fficer)
__________________________________________
Signature Date
PI-PLSP-FCSUPP 08/
10 Page 1 of 1
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COVER-PRO APPLICATION FUNDRAISING CONSULTANT SUPPLEMENT r ual re (Philadelphia Insurance Companies)

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Completed 7 November 2020

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