Retailer Donation Request

*All requests must be made at least 2 months in advance

Name of retailer:*

Date needed by:*

Shipping Address:*

Contact name/information:*

Email Address:*

What is the event and how many people do you expect to be in attendance?*

Is this a request for samples or a gift basket? (We cannot accommodate monetary donations at this time)*

Is samples/product is requested, please provide us with the exact amount needed:*

Do you have a social media presence? If so, please provide number of fans/followers and links to the pages:*

Would you be able/willing to take pictures of our product at the event for us to use/promote on our social media?*