Community Ticket Program Form

Organization Name*

Non-Profit ID Number*

Address*

Street Address Address Line 2 City State ZIP Code

Organization’s Website

Organization’s Mission*

Organization’s Core Areas of Focus*

Organization's Executive Director*

Executive Director Email Address*

Executive Director Phone Number

CTP Key Contact*

CTP Key Contact Email Address*

CTP Key Contact Phone Number

Number of children the organization serves*

Number of tickets requested per game:*

Are you able to receive tickets under short notice (24 to 48 hours in advance)?*

How will tickets be allocated to the beneficiaries of your organization?*

If your organization has a special request regarding game dates, please explain:

Community Ticket Program Agreement*

I, as an authorized representative of my organization, agree to distribute any and all game tickets donated by the Dallas Mavericks solely to beneficiaries of my organization. I understand that tickets are not to be used for fundraising purposes, sold or exchanged under any circumstances. I also understand that misuse of donated tickets or failure to use the tickets will result in loss of eligibility for future ticket distributions.

COMMUNITY TICKET PROGRAM