Host a Circle of Care Essentials Donation Drive
Share your drive details so Circle of Care St. Louis can review and guide you through the required host orientation.
About the Host
Host Name
*
First Name
Last Name
Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Organization or Group Name
Enter "Individual" if hosting independently.
Organization/Group Type
*
Business/Employer
Church/Faith Community
School/College
Civic/Community Organization
Sorority/Fraternity
Professional Association
Family/Friends
Individual
Other
If Other, please describe
*
Tell Us About Your Drive
Proposed Donation Drive Name
Proposed Start Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Proposed End Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Location/Venue Name
*
Full 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
Will donations be collected at more than one location?
*
Yes
No
Additional Locations
Drive accessibility/attendance type
*
Open to public
Limited to employees/members/students
By invitation only
Other
Expected participants
Please Select
Fewer than 25
25–50
51–100
More than 100
Not sure yet
Promoting Your Drive
Approved hosts receive Circle of Care St. Louis branding and promotional guidelines. Any materials using the Circle of Care St. Louis name or logo must follow those guidelines.
How do you plan to promote your drive?
*
Social Media
Flyers/Posters
Email
Organization Website
Employee/Member Communications
Newsletter
Community Event
Media/Public Announcement
Other
If you selected Other, please describe your promotion method.
Do you plan to use Circle of Care St. Louis name or logo?
*
Yes
No
Not Sure
After the Drive
How would you prefer to get collected donations to Circle of Care?
*
We will deliver
Discuss pickup
Not sure yet
Anything else about the proposed drive?
Required Host Orientation & Acknowledgment
BEFORE YOU HOST YOUR DRIVE
Orientation requirements and overview
Acknowledgment 1
*
I understand that I must complete the Circle of Care St. Louis Donation Drive Host Orientation before hosting my donation drive.
Acknowledgment 2
*
I understand that submitting this form does not mean my donation drive has been approved.
Acknowledgment 3
*
I agree to wait for Circle of Care St. Louis approval before publicly promoting my drive using the Circle of Care St. Louis name or logo.
Acknowledgment 4
*
I agree to follow the Donation Drive Host Guidelines and current Circle of Care Essentials Wish List provided during orientation and approval.
Host Electronic Signature
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
SUBMIT MY DONATION DRIVE REQUEST
SUBMIT MY DONATION DRIVE REQUEST
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