Cause Marketing Application

Home Ways to Give Become a Community Ambassador Cause Marketing Application

Please submit this form a minimum of 30 days before the start of your campaign. If you have any questions about this form, please email

General Information

Contact name*

Name of company/organization involved










Campaign Details

Has the promotion been held before? YesNo

If yes, when?

Product/service name

Promotion/service period (date range)

Number of expected items sold

Describe item for sale, and be specific about color, size, flavor, etc., to ensure that the information we post to our website about your campaign is precise and accurate.

Will our name/logo be used on your promotional materials or in publicity?

Please note that the Pancreatic Cancer Action Network will grant permission to use the organization name and a special "benefiting" logo for Community Ambassadors only after your application has been approved and the Community Ambassador Agreement has been signed. Please allow up to five business days for approval of your application.

If yes, indicate type(s) of publicity.

Financial Information

Retail price of item

Dollar amount or percentage of product/service that will be donated

Anticipated total donation (must meet $5,000 minimum)

Apply donation to

If you selected something other than "My campaign" in the dropdown above, please tell us which event, or which team and event, you would like the donation to benefit.

Is there anything else you’d like to tell us about your promotion? Please leave comments or ask questions here.

How did you hear about us?

Type the characters you see in the picture:


Wage Hope With Us

Join us to double pancreatic cancer survival by 2020.

Gear, apparel, accessories and more to show off your purple pride.

Shop Now 

©2018 Pancreatic Cancer Action Network. All rights reserved. Terms of Use | Privacy Policy

Pancreatic Cancer Action Network®, PanCAN®, PurpleStride®, Wage Hope®, Know Your Tumor®, Powerful Knowledge. Personal Treatment.®, Precision Promise℠ and Demand Better For Patients. For Survival.℠ are the trademarks of the Pancreatic Cancer Action Network, Inc.

The Pancreatic Cancer Action Network is registered as a 501©3 nonprofit organization. Contributions to the Pancreatic Cancer Action Network are tax-deductible to the extent permitted by law. The Pancreatic Cancer Action Network’s tax identification number is #33-0841281.