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Food/Funds Drive Questionnaire
Please share your contact information with us.
Please share your contact information with us.
Contact Name:
Email Address:
Phone Number:
Please tell us about your organization.
Please tell us about your organization.
Organization:
Address:
Address 2:
City/Town:
State:
-- select state --
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP/Postal Code:
When do you plan to hold your food/funds drive?
MM
DD
YYYY
Start Date
When do you plan to hold your food/funds drive? Start Date Month
/
Day
/
Year
End Date
End Date Month
/
Day
/
Year
What type of drive are you planning to host?
What type of drive are you planning to host?
Just a food drive
Just a funds drive
Both a food and funds drive
Please describe your food/funds drive plans and provide any other information that can help us support your efforts.
Please describe your food/funds drive plans and provide any other information that can help us support your efforts.
What can we send to help?
What can we send to help?
A copy of our logo
A flyer with our needed food items
Brochures with information about Mid-Ohio Foodbank
Other (please specify)
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