Donation Request Application

- Select all the Times/Days your organization can receive donations -*

Have you applied for a donation from The Servant Garden before?*
What is your organization's mission statement?*

How will your organization use the donation?*

How will your organization's use of The Servant Garden's donation assist or impact the community?*

What will your organization do to educate the population(s) ultimately receiving the food donations from The Servant Garden about The Servant Garden and its mission?*

How will your organization recognize the contribution of The Servant Garden to your mission?*

Would you like to receive our news letter?*

Security Check:*

I certify that I have answered everything on this application truthfully and to the best of my knowledge and have not given any information intended to deceive or commit fraud or made any false statement that might be construed as such.
Your organization is federally-licensed 501(c)(3) non-profit, charitable agency.
Your organization does NOT discriminate in the provision of services unlawfully or in a manner inconsistent with The Servant Garden's policies on the basis of race, religion, color, sex, national origin, age, marital status, mental or physical ability, or sexual orientation.
Your organizations does NOT engage in terrorist activities or is involved in any acts dangerous to human life that are in violation of the criminal laws of the United States of America.