We Believe Alliance
World Record Application Form
World Record Recognition Program Information
Name of Applicant (Organization):
Address:
Contact Name:
Title of Contact:
Phone Number:
###-###-####
Email Address:
e.g: johnsmith@gmail.com
World Record Attempt Description:
Community Organization that will be the beneficiary of the world record attempt:
Description of the organization:
Name:
Address:
Phone Number:
###-###-####
Email Address:
e.g: johnsmith@gmail.com
Contact Name:
Title of Contact:
Date when the world record attempt will be made:
Start Date:
Finish Date:
Where will the world record attempt be made (City and State):
Name of Mayor and City:
