RECIPIENT APPLICATION
About Donate Your Dime*
Whole Foods Market gives 10 cents per bag to customers who re-use their own shopping bags for their purchased
groceries. This program reduces our impact on the environment and now supports local non-profit groups. Customers
will have the choice to accept their cash refund, donate the cash back to the store’s chosen non-profit organization or
to the Whole Planet Foundation.
About the Application Process
Organizations must be a designated 501(c)3 non-profit organization to be considered for this program. Organizations
will be selected for a three month period (approximately 1 full Quarter) and will be notified at least six weeks prior to
the start of their awarded month. Organizations can only participate once every 12 months. Recipient organizations
are expected to promote the event through their website, e-mail blasts and additional promotional vehicles as
appropriate.
Please briefly state the mission and history of your organization.
Which project/projects will the funds from the Donate Your Dime program benefit?
How would you publicize and promote this fundraiser to your members and the public?
Has your organization ever been the recipient of a fundraising event or 5% Community Giving Day at Whole Foods
Market? If so, when and which location?
__________________________________________________________________________________
ORGANIZATION NAME
STREET ADDRESS
CITY/STATE/ZIP
__________________________________________________________________________________
CONTACT NAME
CONTACT PHONE #
__________________________________________________________________________________
CONTACT E-MAIL
501(c)3 NUMBER
__________________________________________________________________________________
CONTACT TITLE
TODAY’S DATE
REFERRED BY
* In order to be considered, please attach your organization’s 501(c)3 letter.
Please submit this completed form and 501(c)3 letter via email as physical forms will not be accepted. Send all
documents to fljax.contacts@wholefoods.com