Donation Request Form - Moxie Kitchen printable pdf download

Donation Request Form

Thank you for considering Moxie Kitchen + Cocktails for your charity or fundraising event. We are a

forward-thinking independent restaurant that seeks to create meaningful and authentic interactions

with our guests and within our community. It is our desire to serve and to be positive contributors in

as many ways as possible.

Every request we receive is given careful consideration. However, given the large number of requests

we receive, we regrettably cannot fulfill all of them. All requests must be submitted by completing the

form below. We do not accept any requests via phone or fax.

Before submitting your request, please review the following:

• Please allow a minimum of 30-45 days for requests to be considered.

• Moxie Kitchen + Cocktails is able support requests for in-kind donations only.

• All in-kind donations requests must be submitted via email or mail for the request to be considered. If your

request is approved, you will receive a confirmation via email within 14 business days of the submittal of

your request.

• Due to the high volume of requests received, we are unable to confirm the status or receipt of requests by

telephone.

• Special consideration will be given to organizations that operate in Jacksonville as well as those that

provide food, health and nutrition education programs, or focus on environmental sustainability. While we

work hard to support as many organizations as possible, we are especially appreciative of those who in turn

support us! Please be sure to mention in your application if your organization has selected us for business

or group dining, or if you are a frequent guest at the restaurant.

• To better serve the entire community, organizations are eligible to receive a donation from Moxie Kitchen +

Cocktails once in a 12-month period from the date of the donation request.

• If approved, arrangement for pick-up / mailing of donations will be coordinated specific to each request.

GENERAL INFORMATION

Today’s Date: ______________________________________________________________________________________________

Organization Name: ______________________________________________________________________________

Contact Name and Title: ____________________________________________________________________________________

Address of Organization: ___________________________________________________________________________________

City:_________________________________________ State: ____________________ Zip Code: ______________________

Phone: ______________________________________ Alternate Phone: ___________________________________________

E-Mail:______________________________________

Website: __________________________________________________

Donation Request Form - Moxie Kitchen