Name of Event and/or Organization
Date of event
City, State & Zip of event location
Purpose of event
Have we donated to your event/organization in the past 12 months?
Type of organization / event:
Benefit for an Individual
Community Wide Celebration/Festival
If other, please describe
If event is a benefit for an individual, please choose a category
Patron (Include Patron number in "Other")
How many people are expected to attend your event?
Who will this event benefit, and how?
How will this event be promoted?
How will Burnett Dairy be promoted?
Anything else you would like to tell us
Attach additional information if necessary
What type of donation/sponsorship are you seeking?
Gift certificate to General Store
Gift certificate to Cheese Store
Please give specifics (amount/value/# looking for)
If approved, who will pick up the donation?
If approved, when would you pick up the donation?
Send me a copy of my responses
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