Donation/Sponsorship Request Form

Donation/Sponsorship Request Form

Each request will be reviewed by an AuBurn Pharmacy team member at the corporate office. We would like to acknowledge each request, but due to the high volume of donation and sponsorship requests we are unable to respond to every request. If your request is approved, we will contact you for the necessary arrangements. Please, no telephone calls. If you are a non-profit, consider registering for our Caps to Cash® Program! For each AuBurn Pharmacy bottle cap turned in you will receive 25¢ for your organization. *Restrictions apply. For more information and enrollment form www.auburnpharmacies.com/caps-to-cash/
Today's Date*

MonthDayYear
Date
The AuBurn Location you Wish to Donate or Sponsor*
Name of Your Organization*
Type of Organization*

General Non-Profit 501(c)(3)School/EducationFor-Profit BusinessOther
Contact Name*

First NameLast Name
Phone Number
Please enter a valid phone number.
Email*
example@example.com
Date of Event (If Applicable)

MonthDayYear
Date
Registration/Donation Deadline

MonthDayYear
Date
Request Type*

Event SponsorshipAthletic or Academic SponsorshipsMonetary DonationMembershipItem / Gift Card DonationOther
Description of Event
Will there be a listing of donors or sponsors posted?

YesNo
If so, do you need a copy of our logo?

YesNo
Please upload any flyers, levels of sponsorship, or your request forms here

Cancelof
Please verify that you are human*
Should be Empty: