Blue Moon Water Charitable Giving Request Form

Blue Moon Water supports many community-minded organizations with donations of spring water. If your organization would like to apply for a water donation, please complete and submit the form below.

Please note:

  • Requests must be received at least 30 days in advance of the event.
  • We will respond to your request immediately by e-mail or telephone call.
  • Determinations of approved donations are typically made within 7 business days.
  • All donations require a signed receipt of acknowledgement from your organization.
Information of organization applying for funds.
Organization:
Street Address:
City:
State:
Zip Code:
Organization contact information.
Contact Name:
Telephone Number:
Email:
Description of event/project.
Purpose:
Size of Audience:
Intended Audience:
Date of Event:
Total Event Budget:
Other Pertinent Information:
What form(s) of Blue Moon Water packaging and dispensing do you need?
20 ounce bottles (How many?):
1.5 liter bottles (How many?):
Mix of both (How many?):
5 gallon jugs with cooler (How many?):
Rolling ice coolers (How many?):
Additional Dispensing Comments:
What on-site signage or brochure locations are available or needed?
Banners (How many?):
Approximate Banner Size:
Coolers (How many?):
Brochure Holder:
Tent:
How will Blue Moon Water be acknowledged for its support in the following media? Organization Newsletter
Radio
Television
Newpaper
Billboards
Other (specify below)
Other:
What other organizations and individuals are supporting this project?
Do you need delivery or set up assistance? Yes No
When would your donation need to be ready for pick-up?
How many complimentary tickets may we receive for this event?
Questions or additional comments
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