Donation Intent Form
* Required
Date:
MM
/
DD
/
YYYY
Organization Name (Donor Name):
*
Your answer
Contact Name:
*
Your answer
Contact Number:
*
Your answer
Contact Email:
*
Your answer
Mailing Address (for thank you notes):
Your answer
Would you like to be listed as a donor on our website?
*
Yes
No
If the answer above is yes, then please send a logo to 12thcan.donation@gmail.com
How did you hear about the 12th Can?
*
From a friend/org
Online/12th Can website
Email
Other:
What kind of donor are you?
*
Individual
Organization affiliated with the University
Other:
Is this your first time donation to the 12th Can?
*
Yes
No
By checking the boxes below, I agree with the following statements and authorize a 12th Can representative to contact me about setting up a donation time.
*
Donation forms must be submitted at least two weeks before the chosen donation day.
Unless otherwise determined by a 12th Can representative, I understand that donation drop offs must be Monday-Friday between 8-5pm.
I understand that I am responsible for setting up the logistics of the donation with a 12th Can representative.
I understand that I am responsible for transporting the product to the 12th Can pantry unless otherwise discussed with a 12th Can representative.
Required
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