Donations

A Bushel and A Peck MN Donation Form 

*Please fill out this form and email it back to contact@abushelandapeckmn.com*

All submitted donations will be taken into consideration. We love giving back to the community and helping out organizations that hold a special place in our heart. We have limited donation funds every year. Because of that, A Bushel and a Peck does have the right to deny your request. 

Date: ____________

Name of organization or event requesting donation:

____________________________________________________________

Address: __________________________________________________

City: ________________State: _____________ ZIP: ______________________

Phone: (__)______________________

Name of Person making request:

____________________________________________________

Contact number if different from above:

(__)___________________________________________

Indicate the purpose for which the donation will be used:

____________________________________________________________

____________________________________________________________

____________________________________________________________

____________________________________________________________

____________________________________________________________

Date of occasion: __________________ Deadline: ________________

Has this organization had previous donations or ads from our company this year?

YES NO

Are you a customer of A Bushel and a Peck Boutique? ____________

Approximate date of the most recent purchase? __________

Additional Comments:

____________________________________________________________________________

____________________________________________________________________________

Thank you for your application.