Thank you for your interest in raising money for The Fund for Public Health in New York City!

This is an application to participate in the 2023 NYC Marathon as a member of The Fund for Public Health in New York City's (FPHNYC) team. The Fund has a limited number of runner spots, and you will be contacted shortly after the submission of this form about approval.  

As a member of the team, we expect you to fundraise a minimum of $3,000 for FPHNYC plus pay the race registration fee of $295. 

Question Title

* 1. Name

Question Title

* 2. Address

Question Title

* 3. How did you hear about The Fund for Public Health in NYC (FPHNYC)?

Question Title

* 4. Why do you want to run for FPHNYC?

Question Title

* 5. How will you ensure you meet your fundraising goal? What ways will you communicate your fundraising page with your family/friends?

Question Title

* 6. Have you fundraised before? If so, what was it for and how much did you raise?  
*Note, answering no will not impact your chances of running for our team

Question Title

* 7. Have you ever run a marathon before? If so, how many?
*Note, answering no will not impact your chances of running for our team

Question Title

* 8. Are you part of any running groups? If yes, please list below.
*Note, answering no will not impact your chances of running for our team

Question Title

* 9. I understand that if I do not raise the $3,000 minimum by Nov 6th, 2023, I will be charged the remaining balance on my credit card on file.  Please sign your name below.

T