Donation Request Form
Bone-a-Patreat
How did you find out about us?
Contact Person
Please complete the following information
Name
First Name
Last Name
Email
example@example.com
Fax Number
Please enter a valid fax number.
Format: (000) 000-0000.
Event Date
Event Time
Company Information
Please complete the following information
Company Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Event/Organization Name
Event Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date Needed
Brief Event Description
Are you requesting anything other than product?
Yes
No
Specify type and quantity
How will the donated product be distributed?
Detail with names of individuals responsible, etc.
How have you determined the quantity requested?
What are the connections with and benefits to Bone-A-Patreat?
Will you provide logo placement for Bone-A-Patreat?
Web
Print
Both
Will you provide banner placement for Bone-A-Patreat?
Yes
No
Please specify banner placement
Size, quantity, and locations
Will you provide Bone-A-Patreat with photos, video or other documentation of the event?
Yes
No
If yes, please advise date they will be provided
Will you distribute store coupons at the event?
Yes
No
Will you distribute business cards at the event?
Yes
No
Submit
Should be Empty: