Date of Application *

MM

DD

YYYY

Date of Event (if applicable)

MM

DD

YYYY

Deadline for Donation *

MM

DD

YYYY

Contact Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone Number *

(###)

###

####

Has your organization partnered with or received a donation from Groovy Donuts before? *

Yes

No

Not Sure

Are you a member of Groovy Donuts’ Loyalty program? *

Yes

No

Not Sure

Is this a recurring event / request? *

Yes

No

Event Type?

Single Day

Multi Day

Are there Donation or Sponsorship Tiers? *

Yes

No

What specific item or donation are you requesting? *

Product (eg, Donuts)

Gift Card

Merchandise

Monetary Donation

End of Day Left Over Donuts

Empty, Sanitized Ingredient Buckets (3-5 gallon)

Other?

Will Groovy Donuts be recognized or promoted as a donor? *

Yes

No

If Yes, How & Where?

Event Signage

Event Website Or Social Media

Verbal or program acknowledgment

Other?