Organization's Tax Information by zbk23844


									Welcome to your first step to raising some serious cash for your organization. Please print in blue or black ink and, keep in mind, this is a charitable donation program, not some previously undiscovered loophole for you to get
a bunch of cheap burritos. Hey, we had to say it. Moe’s Southwest Grill reserves the right to select the organizations we choose to support. Please submit this completed form to the manager of the Moe’s location where you
wish to hold your event. Let’s have some fun and raise some money!

Today’s Date: ___________________________________________________________________________________________________

Fundraising Organization: ________________________________________________________________________________________

Moe’s location: _________________________________________________________________________________________________

Fundraiser Date: _______________________________________________________________________________________________

Describe Event: ________________________________________________________________________________________________

Organization Information: ________________________________________________________________________________________

               Name: _________________________________________________________________________________________________
               Address: _______________________________________________________________________________________________
               City: _____________________________________________________ State: __________________________Zip:__________
               Contact Name & Position: __________________________________________________________________________________
               Phone number: __________________________________________________________________________________________
               Fax number: ____________________________________________________________________________________________
               Email address: __________________________________________________________________________________________

Mailing address of check: _________________________________________________________________________________________

               Name to make it out to: ___________________________________________________________________________________
               Address: _______________________________________________________________________________________________
               City: _____________________________________________________ State: __________________________Zip:__________

Organization’s Tax Information:

               Federal Tax ID#:___ ___ ___ ___ ___ ___ ___ ___
               Are you recognized by the government as a non-profit organization? Y/N ___________________________________________

Agreement terms:
Approval of this agreement is at the sole discretion of Moe’s Southwest Grill. Please note that this agreement must be approved at least three (3) weeks before your scheduled fundraiser event. This agreement may be
terminated and/or cancelled on thirty (30) day’s written notice at anytime during the term of this agreement by either party. The above organization will promote this fundraiser event for the above Moe’s Southwest Grill
location only. The proceeds for the event will be up to 20% of the pre-tax sales receipts for food and beverages. Participants must purchase a beverage with their meal in order to receive credit towards the organization.
One beverage per meal purchase. One flyer required per transaction. No other coupons or discounts may be applied. By signing this contract, I understand that all flyers are to be distributed prior to the event, and under no
circumstance are flyers to be handed out in the restaurant, parking lot, or vicinity. The event traditionally takes place between the hours of 5 p.m. and 8 p.m. unless otherwise approved and noted on the contract by the General
Manager of the above restaurant. A check will be mailed to the organization within 4-6 weeks after the event. No guarantees or warranties of any kind are made by either party hereto as the anticipated success of this event.

The terms above are agreed to and accepted by:
Organization Representation:_________________________________________ Date : _______________________________________

     Restaurant Store Number: _______________________________________________________________________________
     General Manager’s Approval Signature: ______________________________________________________________________
     Corporate Signature: ___________________________________________________________________________________

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