PLEASE ANSWER ALL QUESTIONS BELOW

    TELL US ABOUT YOUR ORGANIZATION

    Organization's name:

    Brief description of how your organization supports our community:

    Organization's 501(c)3 / EIN:

    Organization's website:

    Organization's Facebook:

    Organization's Instagram:

    Does your organization serve local or national?

    What quarter would you like to participate in?:

    Reason for choosing a specific quarter?

    Have you previously obtained a wine donation form Carruth Cellars?
    yesno

    If yes, please provide the date of the most recent donation

    TELL US HOW TO CONTACT YOU

    What is your name?

    What is your email address?

    What is your phone number?

    What is your role in the organization?

    Are you a member of Carruth Cellars wine club?
    yesno

    BEFORE YOU SUBMIT

    Can you provide proof of 501(c)3 status? This can be copy of copy of your Letter of Determination or Form 990 from the IRS that includes your EIN number (required)
    yesno