Central Square Florist- Request for donation for Charitable Event.

Each year, our company allocates a budget to support community activities through contributions. We are pleased to do our part to assist community programs. However, requests have become so numerous that they exceed our financial capabilities.Therefore, we must fairly distribute our support to as many organizations as possible within our means. In order for us to evaluate your request, we ask that you complete this form and return it to us at least 14 days prior to the event. Thank you for your cooperation. Email to info@centralsquareflorist.com

Date ____________________________

Date of event or publication_______________________
Organization requesting donation ___________________________________________________
Is this a for-profit or non-profit organization? ~ For-profit ~ non-profit
Address _______________________________________________________________________
Telephone _________________________Contact Person _______________________________
Purpose of request_______________________________________________________________
Product or amount of advertising requested ___________________________________________
Has your organization requested previous donations or ads from us this year?________________
Has your organization requested previous donations or ads from us last year? ________________
Is this organization a current customer of Central Square Florist?__________________________
Is this organization a current customer of other flower shops? ____________________________
Name of person making request ____________________________________________________
Address
Telephone _______________________ Are you a customer of our shop? _________________
E-mail address _______________________________________
How long have you been a customer?______________ Date of last purchase _______________
If you are not a customer, who (or what) prompted you to make this request ________________
List other florists being contacted for this request _____________________________________
Please list other firms contributing to your organizations activities. For example, who is contributing the
event site, entertainment, meals/food, beverages, or other items?
Firm:
Will specific mention be made of our support? ____ If yes, how ________________________
Will you provide us with a web link from your web site in recognition of our donation? ______
Who will pick up the donation? ____________________________ When?

FOR OFFICE USE ONLY
Date Received Received By Approved By If Not, Reason Product/Amount