Each year, our company allocates a budget to support community activities through contributions. We are pleased to do our part to assist community programs. However requests have become so numerous that they exceed our financial capabilities.

Therefore, we must fairly distribute our support to as many organizations as possible within our means. In order for us to evaluate your request, we ask that you complete this form and return it to us at least 21 days prior to the event.

Please email your request to [email protected].

Thank you for your cooperation.

*Today's Date

*Date of Event or Publication

*Organization Requesting Donation

*Is this a for-profit or non-profit organization?

Non-Profit

For-Profit

*Address of Organization Address

City

State / Province / Region

Zipcode

Country

*Telephone

*Contact Person

*Purpose Of Request

*Product or amount of advertising request

*Has your organization requested previous donations or ads from us this year?

*Has your organization requested previous donations or ads from us last year?

*Is this organization a current customer of Patterson's Flowers?

*Is this organization a current customer of other flower shops?

*Name and Phone Number of person making this request.

*Address of Person making this request Address

City

State / Province / Region

Zipcode

Country

*Email Address of Person making this request

*How long have you been a customer?

*Date of Last Purchase

*If you are not a customer, who or what prompted you to make this request?

*List of other florist being contacted for this request.

*Please list other firms contributing to your organizations activities. For example, who is contributing to the event site, entertainment, food and beverage or other items?

*Will specific mention be made of our support?

*If yes, how?

*Who will pick up the donation?

*On what day?

*Anything else you would like us to know about your request?