2013 Governor's Bowl Registration

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2013 Governor's Bowl Registration - State Agencies

Use this registration form if you represent a Virginia state agency. Each location with an agency must register separately in order to determine which food bank receives your collected food and funds.

Name *

Please enter the name of the contact person for your state agency at this location.

State Agency Name (A - E)

Please select the name/acronym for your state agency.

State Agency Name (F - L)

Please select the name/acronym for your state agency.

State Agency Name (M - R)

Please select the name/acronym for your state agency.

State Agency Name (S - Z)

Please select the name/acronym for your state agency.

If you did not find your agency name in the lists above, please type it here.

Phone Number *

Please enter the preferred phone number for the contact person at this location. He/She will be contacted by your local food bank representative.

State Agency Address - Street *

Please enter the street address of your state agency location.

State Agency Address - CITY *

Please enter the city of your state agency location.

State Agency Address - State *

Please indicate that your state is Virginia below.

Virginia

Required

State Agency Address - ZIP CODE *

Please enter the zip code of your State Agency location.

Email of Contact Person *

Please enter the email address of the contact person for your State Agency location.

Submit

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