Virtual Food Drive Registration Form

Contact Information
Organization Name*
First Name*
Please identify your Food Drive Coordinator
Last Name*
Email*
Address*
Street Address Address Line 2 City State ZIP Code
Street Address
Address Line 2
State
Zip Code
City
Phone*
Coordinator's Daytime Phone Number
Event Information
Virtual Food Drive Start Date*
Date Format: MM slash DD slash YYYY
Virtual Food Drive End Date*
Date Format: MM slash DD slash YYYY
Describe your Virtual Food Drive goals and expectations below.
Virtual Food Drive Goal
- $100
- $250
- $500
- $1000
- $2500
Donation Information
Are you interested in a customized URL?*
- Yes
- No
Unless noted, URL will contain organization, group or company name to the best ability of Hunger Task Force.
Do you have a preference on the name in your URL?
Email
This field is for validation purposes and should be left unchanged.

Contact Information