Community BenefitBar

Customize Your Organization’s Tool Bar Today!

Community BenefitBar Toolbar Application

Simply create your toolbar by filling out all required fields

Organization Name

Organization Contact Name


First	Last

Contact Phone Number:

(XXX)	XXX-	XXXX

Contact Email Address

Address

Street Address

Address Line 2


City	State	Zip

Use space below to delineate International address information.

Special Address and Payment Area for Foreign Participants

We use only PayPal as the payment method for organizations outside of the USA.

Agreement (Click here to review the Agreement)

	I have read the contract and I agree with the terms.
	I am of legal age to sign a binding agreement in the country I reside.
	I agree to promote clicking on sponsored links only out of genuine interest in that information. I understand that clicking on sponsored links for the sole purpose of raising money is an abuse of the program and will lead to our organization’s toolbar being deactivated.

Authorized Signature - Acknowledges Agreement

Team Member Name* (person who introduced our technology and service to you)


First	Last

Team Member Phone Number

(XXX)	XXX-	XXXX

Association Team Member belongs to:

The association that introduced the toolbar technology to the Team Member

How many supporters do you have that are passionate about your organization's needs?

TIME TO DESIGN THE TOOLBAR - There are Toolbar Samples at the top and bottom of this form to help you understand where the links are placed on your toolbar.

Name Of Organization On Toolbar

URL of Your Organization (Website Address)

Color Scheme

Logo (Optional)

$100 Cost strictly optional and not recommended (per widget logo)

While we do not recommend the use of logo's on widgets, if your organization insists , our design team will need a picture that is 22 pixels in height and should not be wider than 150 pixels. This should be uploaded and sent in Bitmap, JPEG or PNG file form. We always recommend raising dollars without you having any expenses. Since the cost of each image is $100.00, our recommendation is to save your organization any outlay of dollars by not using special logos.

Choice #1 Name of Link

Choice #1 URL

Copy and Paste the Correct URL (Web Address) Above

Choice #2 Name of Link

Choice #2 URL

Choice #3 Name of Link

Choice #3 URL

Additional Information, Request, Details

Click for a new image

Enter the code (above) prior to submitting your request.

If you have any questions while filling this form out please email; contact BenefitBar Support or call your Account Manager or call 314-616-1954

Please use this as a guide when designing your customized toolbar