EmailMe Form - Special Events Support Request

Company/ Organization Name:

Contact Name *

First Last

Email *

Phone *

### - ### - ####

Web Site

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Name of Proposed Event or Promotion: *

Date(s) of Proposed Event or Promotion (estimated): *

MM / DD / YYYY HH : MM AM/PM

Brief description of event/ promotion: *

Plan for Publicity and Promotion, including Foodbank logo usage and materials (posters, flyers, etc.) *

Are there any other beneficiaries of this event or promotion? *

Yes

No

Please know that many companies are already supporting Mid-Ohio Foodbank and may not wish to make additional donations to your event. To avoid conflicts, please list any companies that you plan to solicit for your event benefiting Mid-Ohio Foodbank.

Estimated Total Raised: *

$ Dollars . Cents

Estimated Total Donation: *

$ Dollars . Cents

All donations must be submitted within 30 days of completion of the event or promotion.
Expected date of donation payment to Mid-Ohio Foodbank:

MM / DD / YYYY