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GoGo squeeZ Donation Request Form
Thank you for the invitation to your event. We will respond within 2 weeks to your request. Please make sure to allow 3-4 weeks lead time in order to arrange for delivery of the product for your request.
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Date of Event
MM
/
DD
/
YYYY
Event, program or organization name
Your answer
Location of event or program (city/state)
Your answer
How many GoGo squeeZ pouches are you requesting?
Your answer
Your Name
Your answer
Your E-mail
Your answer
Your Phone Number
Your answer
Brief description of event or program:
Your answer
Shipping contact name: *
Your answer
Street address: * (Ex. 123 Main Street Apt. 4)
Your answer
City (Ex. New York)
Your answer
State (Ex. NY)
Your answer
Zip (Ex. 10001)
Your answer
Phone Number (*For shipment)
Your answer
Is this shipping address a home or business? *
Your answer
Please indicate how the products will be used, whether the GoGo squeeZ logo or messaging will be included in any materials, and if/how GoGo squeeZ can be involved to help promote.
Your answer
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