Sprout Donation Request Form

We are proud to serve and support the community in which we do business. Sprout has an enthusiastic but limited budget for charitable contributions. Please fill out this form so we can prioritize and expedite our donations. Donation Guidelines: • We donate to non-profit Worcester MA based organizations. • We donate our products – flowers and plants. • We can consider only donation requests that are submitted on this form. • Donation requests are filled on a first-come first-served basis. Because of the volume of requests and our limited budget, we recommend you apply at least 2 months in advance to be considered. Preference is given to: • 501(c)3 organizations • Organizations which have purchased with us in the past year. • Organizations which support causes near and dear to us – city beautification, arts & culture, and childhood education & wellness.

About Your Organization
Organization Name: Address: Date of Event: Contact Person: Phone: Email: Venue: Is this a 501(c)3 organization? YES / NO (Please attach 501(c)3 status & ST-2 if Yes) YES / NO Has this organization purchased with us in the past year? What is the mission or cause of this organization?

About Your Event
Describe your event: Number in attendance: How is this event promoted? How will Sprout's donation be acknowledged? Are other items being donated - food, venue, entertainment, etc.? Specify if Yes: Are any vendors being paid? Specify if Yes: Are other florists being contacted with this request? If Yes, whom? Will our donated products be raffled/ auctioned? If No, will our donated products be given away? Given to whom if Yes? YES / NO YES / NO YES / NO YES / NO YES / NO

Your Request
What are you requesting? How will it be used? Please be specific.

Please fill out this form completely and return to:

Sprout
118 A June Street Worcester MA 01602 asksprout@gmail.com

_________________________________________________________________________________ _________________________________________________________________________________ This section for internal use. Score: Donation is: Approved Declined Donation value: Item(s) donated:

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