Cheers to Change: Happy Hour Pledge — October 2026 Domestic Violence Awareness Month
Partner pledge form for local bars, restaurants, lounges, breweries and venues supporting Allen Community Bloom Project (ACBP). During October, participating establishments pledge happy hour donations, may opt into gift matching, and can request promotional and payment follow-up materials. Use the purple DV awareness theme.
Establishment Information
Establishment Name
*
Type of Establishment
Please Select
Bar/Lounge
Restaurant & Bar
Brewery/Taproom
Winery/Wine Bar
Nightclub
Hotel/Casino Venue
Event Venue
Other
Street Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Website
Social Media Handles
Primary Contact Full Name
*
First Name
Middle Name
Last Name
Title / Role
Email
*
example@example.com
Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Contact Method
Email
Phone
Text
Happy Hour Details
Participation timing for October
*
Every day in October
Weekdays only
Specific days of the week
Specific dates
If specific days or dates, please specify
Happy hour days and times
*
Estimated average happy hour transactions per day
*
Choose Your Pledge
Select your pledge options
*
$1 from every happy hour sale
$1 from a featured Cheers to Change signature purple cocktail or mocktail
$1 from every draft beer / featured local brew
$1 from a featured happy hour appetizer or food special
$1 from every glass or bottle of a featured wine
Zero-proof / mocktail option so every guest can participate
Round-up at checkout (guests round up their bill to the nearest dollar)
Host a Cheers to Change night with ACBP present (info table, survivor speaker, or trivia)
Display ACBP awareness materials (table tents, coasters, restroom resource cards)
Staff wear purple on a chosen day
Other
Describe your signature drink, special, or custom idea (name, price, description)
Gift Matching
Would you like to offer a gift match?
*
Yes — match 100% dollar-for-dollar
Yes — match 50%
Yes — match up to a set cap
Not at this time
Maximum match amount
Recognition & Marketing
Business name as it should appear in ACBP promotions
*
Business logo upload
*
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Permission to feature your business in ACBP social media, website, and event materials
*
Yes
No
Would you like a digital toolkit (social graphics, table tents, captions)?
Yes
No
Payment & Tax Documents
Completed IRS Form W-9
*
Upload a File
Drag and drop files here
Choose a file
Cancel
of
How will funds be remitted?
*
Check payable to Allen Community Bloom Project
Online donation link
ACH/bank transfer — ACBP will send instructions
In-person drop-off
Acknowledgement
*
I acknowledge that donations will be remitted by November 15, 2026.
Would you like a donation acknowledgment letter for your records?
*
Yes
No
Pledge Agreement
Agreement Statement
I agree
*
I agree
Authorized Signer Printed Name
*
First Name
Middle Name
Last Name
Signature
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Anything else you'd like us to know?
Submit Pledge
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