iPad Evaluation

About Fundraising Programs

Purpose

Chick-fil-A Costa Mesa desires to have a positive impact in our community and we aim to support as many schools and organzations in our local Newport-Mesa service area as possible.

Planning

As you can imagine, there are a number of logistics that we must consider before we can fulfill a request. With this in mind, we kindly ask for a minimum of 30 days notice prior to an event to provide the best opportunity for program enrollment.

Communication

Upon submitting your request, our Community Relations team will be notified and follow up with you within 7-10 business days. To ensure the most efficient communication, we ask that you do not contact store-level staff directly, as our Community Relations team operates remotely and in-store team members will not have access to the status of your submission.

Submission Date*

MonthDayYear
Date
Submission Time*

Hour Minutes

AM/PM Option

Your Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
May we text you at this number?*

YesNo
Which program are you interested in joining?*

You Sell - Chicken Sandwich Resale ProgramWe Sell - Chick-fil-A Pop-up

Is your organization a non-profit Newport-Mesa school or organization?*

YesNo

Will you be able to provide proof of your non-profit status upon request?*

YesNo
Organization Type*
Organization Name*
Who does your Organization primarily serve?*
Tell us briefly about the purpose of your Organization's service in the community
Organization Address (may not be the location of your event)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Organization's Website
If you have a site about your organization or event, please provide it here

Will the event be happening in Costa Mesa, CA?*

YesNo

Is there at least 30 days between now and when your event is happening?*

YesNo

WARNING: Since your event is less that 30 days away, your request may not be able to be considered by our team as there are a number or logistics we must coordinate to support requests.

While you my still continue with your request, our Community Relations team kindly requests 7–10 business days to review, process, and follow up on your request.

To ensure the most efficient communication, we ask that you do not contact store-level staff directly, as our Community Relations team operates remotely and in-store team members will not have access to the status of your submission.

Event Date*

MonthDayYear
Start of Event*

Hour Minutes

AM/PM Option
End of Event*

Hour Minutes

AM/PM Option
How many attendees will be at your event?*
If providing an estimate, please provide us with the most conservative estimation

Minimum Attendee Requirements

You Sell • Chicken Sandwich Resale Program: Requries a minimum order of 100 sandwiches

We Sell • Chick-fil-A Resale Program: Is best for events with 250+ attendees.

Additional restrictions and limitations may apply.

Will Chick-fil-A be the only vendor who sales food or beverages at your event?*

YesNo

How many other vendors will be at the event?*
Please provide any additional details about vendors, such as: selling food, just selling drinks or desserts, etc
Is the event happening at the same address as your Organization's Address?*

YesNo
Event Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
If there anything else you would like to share with our team in considering your request?

WARNING: In general, employment with the company for 12 months is required before a request can be fulfilled. You can review the eligibility requirements for your specific case by reviewing the Time Away from Work section of the Employee Handbook. If you wish to continue with your request you may do so below.

Alternatively, if you need to submit your written resignation, you can do that using this form.

Next Steps

Our Community Relations team kindly requests 7–10 business days to review, process, and follow up on your request. To ensure the most efficient communication, we ask that you do not contact store-level staff directly, as our Community Relations team operates remotely and in-store team members will not have access to the status of your submission.

Important, read before signing

By signing below I, {contactName}, am stating that I am an authorized representative of {organizationName}.

I confirm that the information provided in my request is truthful and accurate to the best of my knowledge. I also understand that submitting this request does not guarantee approval or fulfillment, and that Chick-fil-A Costa Mesa reserves the right to determine eligibility and capacity for fulfillment at their sole discretion.

I also understand that providing false or misleading information may disqualify myself or my organization from participating in current or future programs offer by Chick-fil-A Costa Mesa.

Requestor's Signature*
Should be Empty: