Donation/Sponsorship Request Form

We would love to hear from you! Please fill out this form and we will get in touch with you shortly.

Organization Name*
Federal Tax I.D. Number*
Contact Name and Title*
Address*
Street AddressAddress Line 2CityState / Province / RegionZip / Postal Code
Contact Phone*
Contact Email*
Date of Request*
Type of Donation / Sponsorship*
- Event
- Product Donation
- Monetary Sponsorship
- Logo Graphics Sponsorship
Event Name
Date of Event
Event Description
Event or office location*
- Bend/Central Oregon
- La Porte/Northern Indiana
- Union City/Bay Area California
What is the mission of your organization?*
Please describe the community that the donation benefits:*
Please quantify how many community members the donation benefits, if possible:
What percentage of contribution goes to program expenses?*
If donation request is for product, are you selling it or giving it away?
- Selling Product
- Giving Product Away
Product and quantity requested or amount requested:*
Preferred Date and Time for Donation Pick Up
(Available pick-up days and times: Bend and LaPorte - Monday – Friday, between 8am to 4pm; Union City – 12:30 PM to 2:30 PM Monday - Friday)
What benefits/recognition would American Licorice Company receive if this donation/sponsorship were to be granted?*
• Please allow two weeks upon receipt of request for a response via e-mail and/or letter. No phone calls please.
• No donations/sponsorships will be granted unless received at least fifteen (15) business days prior to event.
• All donation/sponsorship request forms must be completed in full
or will not be considered.
• Attach any additional information regarding the event/cause you wish to be considered.
• American Licorice Company participates in a limited number of monetary sponsorships. The majority of donations granted are for product only.
• American Licorice Company will do its best to support you in your efforts to achieve a successful event, although we may not be able to fulfill your request OR we may not be able to fulfill your request in its entirety.

Donation/Sponsorship Request Form

Donation/Sponsorship Request Form

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