Request edit access
Donation Request
Part of our mission at The Barley House is to give back to our local community, which is the backbone of our success. If you would like The Barley House to donate a gift card to your New Hampshire organization or special cause, please fill out our request form. (Note: The Barley House does not donate cash)

•    All gift card donations must be picked up at The Barley House location that you are contacting.
•    All request must be made 2 weeks in advance of event.
•    The Barley House will donate up to 2 – $15 gift cards depending upon the request.

Sign in to Google to save your progress. Learn more
Email *
Name *
First and last name
Phone number *
Organization / Company *
City / State / Zip Code *
If your organization is a non-profit, please provide Tax I.D.
Describe event *
Date of event *
Screen capture The Barley House logo to use for your marketing materials.
Clear form
Never submit passwords through Google Forms.
This form was created inside of The Barley House. Report Abuse