North Carolina Alcoholic Beverage Control Commission - Industry Promotion Approval Form Page 3

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Attachment A
Industry member: ___________________________________________________________________________________
Contact person / telephone or email: ____________________________________________________________________
Contribution / donation etc.: ___________________________________________________________________________
Industry member: ___________________________________________________________________________________
Contact person / telephone or email: ____________________________________________________________________
Contribution / donation etc.: ___________________________________________________________________________
Industry member: ___________________________________________________________________________________
Contact person / telephone or email: ____________________________________________________________________
Contribution / donation etc.: ___________________________________________________________________________
Industry member: ___________________________________________________________________________________
Contact person / telephone or email: ____________________________________________________________________
Contribution / donation etc.: ___________________________________________________________________________
Industry member: ___________________________________________________________________________________
Contact person / telephone or email: ____________________________________________________________________
Contribution / donation etc.: ___________________________________________________________________________
Industry member: ___________________________________________________________________________________
Contact person / telephone or email: ____________________________________________________________________
Contribution / donation etc.: ___________________________________________________________________________
Industry member: ___________________________________________________________________________________
Contact person / telephone or email: ____________________________________________________________________
Contribution / donation etc.: ___________________________________________________________________________
Industry member: ___________________________________________________________________________________
Contact person / telephone or email: ____________________________________________________________________
Contribution / donation etc.: ___________________________________________________________________________
Industry member: ___________________________________________________________________________________
Contact person / telephone or email: ____________________________________________________________________
Contribution / donation etc.: ___________________________________________________________________________
Industry member: ___________________________________________________________________________________
Contact person / telephone or email: ____________________________________________________________________
Contribution / donation etc.: ___________________________________________________________________________

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