Community Relations Advertising Request

Fields marked with an * are required

Amount Requested *

Requested Medium *

Date Copy Due *

Publication Date *

Distribution Quantity *

Please describe the primary function of your organization and the clientele it serves: *

Please indicate breakdown of overall contribution dollars to this project:

To overhead operations *

To benefit cause/constituents *

Please describe why your organization is requesting a grant from Chief Supermarkets.

What food related sponsors are participating in this project?

Describe in detail your distribution plan:

Supporting documentation (optional)

Organization *

Address *

City *

US States *

Zip *

Phone *

Fax *

Email *

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