DONATION REQUEST FORM

We are proud to be a community partner and help provide needed assistance to our non-profits, education, and health organizations.

Due to the increase in volume of donation requests, we have implemented an online donation request form.  We ask for a minimum of 90 days notice. Incomplete requests will not be considered. If your request has been approved we will email you a letter of notification. Only requests made by submitting the online form will be considered. Phone solicitations will not be accepted.

Thank you,

Donation Request - Wine & Cider

*First Name

*Last Name

Company

*Address

Address 2

*City

*State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

*Zip Code

*Phone

*Email

*Are you a Goose Ridge Wine Club Member Yes No

*Beneficiaries of the Event or Organization

*Date of the Event or Activity

*Location of Event/Activity

*Description of Event/Activity

*How many people are expected to attend?

*What would you like us to donate at this event? To have Goose Ridge staff pour wine at our event
Wine to be consumed at our event
A live auction item
A silent auction or raffle item
A Wine Tasting Certificate
Other

If you are asking for wine, approximately what would you like?

*How will we, or our contributions, be showcased?

*In addition to your request, we would like to make a promotional offer to your members and or guests. What methods are available for us to directly communicate this offer?

*Approximately how many other wineries will be participating?

*Is this tax-deductible? Yes No

Federal Tax ID Number

*Have you received a donation from us in the past two years? Yes
No
Don't Know

Leave this field blank:

Submit