Request For Donation / Advertising
(Please print out this form, fill it in completely and mail / fax / email to us)
Although we receive many more requests than we can financially support, we want to be
as supportive to our community as possible. Please answer all of the questions (as best as
possible) on this form so that we can evaluate your request. We will notify you of our
decision by phone / email / letter within one week after you complete and return this
form. Thank you for bringing this opportunity to our attention.
Name of organization requesting donation:
Address:
Phone:
Fax:
Briefly describe the organization / event and its purpose:
Your Name:
Your Address:
Your Phone:
Type of Request (Use reverse side if more space is needed)
Merchandise
Advertisement
Specific Item Requested:
Size of ad:
How it will be used:
Name of Publication:
Event:
Cost of ad:
Date / Time:
Deadline:
Place:
Who will attend:
Cash Contribution
How many will attend:
Amount:
Is media coverage planned:
Date required:
How will it be used:
Artisan Floral & Gift Boutique
106 N Union St-Bryan, OH 43506
Phone 419-636-2648 Fax 419-636-6096
artisanfloral@frontier.com
Request For Donation / Advertising
Some Information About You: (Use reverse side if more space is needed)
1. Have you/your organization received a donation from us previously? When?
What was donated?
2. Is your organization a customer of our shop? When was its last purchase?
3. Are you a customer of our shop? When was your last purchase?
4. Is there a florist member of your organization?
5. What else is being donated for this event? By whom?
6. Are you a 501 (C) (3) organization?______Nine Digit Employer ID #__________
Artisan Floral & Gift Boutique
106 N Union St-Bryan, OH 43506
Phone 419-636-2648 Fax 419-636-6096
artisanfloral@frontier.com