United Supermarkets :: Community Involvement

Donation Request Form

Please complete the Donation Request Form below and attached supporting details. In order to allow sufficient time to review each request, all requests should be submitted at least three weeks in advance of the date the donation is needed. All fields required.

Date of Request:
Date Needed:
Name of Organization Requesting Donation:
Does Organization have 501(c)(3) Nonprofit Status?: Yes No
Number of Individuals Touched By This Organization :
Name of Contact Person:
Address:
Phone:
City:
State:
Zip Code:
Email Address:
Select the store you most frequently shop:
Type of Donation Requested?: Cash/Gift Cards; Merchandise Event/ Sports Sponsorship; Ad
If cash or gift card donation, amount requested:
If merchandise donation, specify exact description and quantities requested:

If Event, Please Give Name, Date and Purpose of Event:


If Sports Team, Specify Details:
If Ad, Specify Size (width x height), Color or B&W, Deadline, Format and E-mail Address to Send Digital Artwork: