Organization Name*
Federal Tax I.D. Number*
Contact Name and Title*
Address Line 1*
Address Line 2
City*
State*
Zip*
Contact Phone*
Contact Email*
Date of Request
Event Name
Amount Requested*
Date of Event
Event Description
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?*
What benefits/recognition would American Licorice Company receive if this donation/sponsorship were to be granted?*

No donations will be granted unless received at least thirty (30) 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 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.
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