Event and Donation Online Application for Natural Grocers by Vitamin Cottage

Organization Name:*

Do you have a 501-C(3) #:*

Event Address:*

City, State Zip:

Website URL:

Mission Statement:*

Coordinator Contact
and Phone #:*

Coordinator Email:*

Name of Event:*

Date of Event:*
mm/dd/yyyy

Type of Event:*

Goal of Event (description):*

Expected Attendance:*

Previous Year's Attendance:*

Did Natural Grocers participate in previous events:*

Yes No

(Note: Previous participation does not guarantee future participation)

If so, list previous Natural Grocers contact person:

How will Natural Grocers be acknowledged for this donation:*

How will funds raised from this event benefit the local community around your Natural Grocers store:*

Guest Speaker

Subject Matter:
Length of Speech:
Start Time:
Other Comments:

Booth* (includes NGVC representative, literature and product samples)

*NGVC offers in-kind services, products or gift basket in lieu of booth fees.

Setup Time:
Teardown Time:
Event Hours:
Will Table, 2 chairs and trashcan be provided?	Yes No
Other Comments:

Donation (please check type of items being requested)

	Food (please list suggestions):
	Gift Basket
	Entry blanks for gift basket drawing