Exit this survey Harvest for Hunger 2015 Drive Sign-up Question Title * 1. Campaign Coordinator Information: Name: Title: Email Address: Phone Number: Question Title * 2. Organization Information: Organization Name: * Address: * Address 2: City/Town: * State: * -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP: * Number of Employees: * Question Title * 3. Type of Organization: Please Select One Type of Organization Company Independent/Small Business Membership Association Nonprofit Organization Government Agency School/Educational Institution Civic Group Faith-Based Organization Other Type of Organization Please Select One menu Question Title * 4. President or CEO Information (for leadership and recognition events): Title: * Prefix: * First Name: * Last Name: * Email Address: Question Title * 5. We plan for our Harvest for Hunger drive to take place during the following dates: Start Date: Date End Date: Date Question Title * 6. 2015 Campaign Goal: Question Title * 7. Ways to support Harvest for Hunger 2015: We will set a goal to increase our support of the campaign by at least 10% We will make a corporate gift to the campaign in addition wo our employee food and funds drive We will have a representative attend the Harvest for Hunger Kickoff on Wednesday, February 24 at 9AM at the Greater Cleveland Food Bank We are interested in supporting Market at the Food Bank, the annual Harvest for Hunger benefit and celebration, the evening of May 3rd and would like additional information about sponsorship levels Question Title * 8. Coordinator Outreach: I am coordinating a campaign for the first time I'd like to schedule my group for a tour of the Greater Cleveland Food Bank I'd like to have a Harvest for Hunger staff member visit our meeting/campaign event I'm interested in sharing my Harvest for Hunger experience by mentoring a new campaign I am willing to recruit organizations in my industry to join Harvest for Hunger I am interested in volunteer opportunities at the Greater Cleveland Food Bank Question Title * 9. Organization's Online Information: Website Twitter Handle Facebook Page Question Title * 10. Please add these members to my organization's Harvest for Hunger email list: Name 1: Email 1: Name 2: Email 2: Name 3: Email 3: Question Title * 11. How would you like to receive your coordinator kit? Please email PDFs of the coordinator kit I will pick up a coordinator kit at the Food Bank Please send the coordinator kit in the mail Other (please specify) Done