Cooperatives Involvement in the Community

As we are owned and lead by local community members, it is important for us to give back. Thank you for taking the time to fill out the application. We hope we can support your causes! Please complete the information in the form below or download and print this form to submit as directed on it.

Donations and Sponsorship Form

Requesting Organization:

Name of Contact Person:

Is this a charitable 501(c)3 Organization?

Yes No

Mailing Address:

City:

State:

Zip Code:

Email:

Phone:

Describe your project or event and state the goals/purpose:

Date of event or publication:

Is this event:

One-Time Annual

Indicate amount and type of product, service or funding requested:

(Cash, gift certificates, merchandise, ad sponsor, etc)

If a financial request, please indicate who check should be payable to:

How will this donation be used:

Date Donation or Sponsorship is Needed By:

How will sponsors be recognized:

Is a logo or ad needed?:

Indicate preferred format type and email address to send it to. Ad size if applicable

Additional Details:

Security Code