We at DeBrand are tremendously appreciative of the success we've had in our community. We have therefore made a point of giving generously to many worthy causes. Every day we receive numerous charitable requests and while it would be impossible for us to fulfill all the requests we receive, we are happy to play an active role in supporting our community.

Please fill out the following form to make a charitable request

PLEASE NOTE: All fields with the exception of fax are required.

Organization Name:
Contact Person:
Email Address:
Street Address:
City:
State:
Zip Code:
Contact Phone:
Fax:

Federal Tax Identification Number*

*(proof of nonprofit status required to be eligible)

Has DeBrand supported your organization in the past?

Yes No

If yes, please describe when and how: Describe the event for which products are being requested How many guests are expected? Items requested for donation with quantity desired*

*(DeBrand guidelines prohibit us from making cash donations. DeBrand products are the only donation
that will be considered.)

How will the donated product be used? How will DeBrand be promoted?

Will you provide DeBrand with the names and email
addresses of the guests receiving the chocolates?

Yes No

Desired product pickup date: