Company/Organization*

Phone*

Address 1*

Address 2

City*

State* -- SELECT YOUR STATE --ALABAMAALASKAARIZONAARKANSASCALIFORNIACOLORADOCONNECTICUTDELAWAREDISTRICT OF COLUMBIAFLORIDAGEORGIAHAWAIIIDAHOILLINOISINDIANAIOWAKANSASKENTUCKYLOUISIANAMAINEMARYLANDMASSACHUSETTSMICHIGANMINNESOTAMISSISSIPPIMISSOURIMONTANANEBRASKANEVADANEW HAMPSHIRENEW JERSEYNEW MEXICONEW YORKNORTH CAROLINANORTH DAKOTAOHIOOKLAHOMAOREGONPENNSYLVANIARHODE ISLANDSOUTH CAROLINASOUTH DAKOTATENNESSEETEXASUTAHVERMONTVIRGINIAWASHINGTONWEST VIRGINIAWISCONSINWYOMING

Zip*

Have you requested products in the past?*

YesNo

If yes, whom did you work with at Turkey Hill Dairy?

Event Date*

Event End Date (if multi-day event)

Event Name*

Event Location*

Event Description*

Whom the proceeds will benefit*

Expected attendance*

How will our donation be recognized in promotion of the event, at the event and/or post-event?*

Type of product desired

Ice CreamDrinksProduct Certificates

Can you pick up your products at the Turkey Hill Experience (301 Linden Street, Columbia, PA)*

YesNo

Amount of product desired*

First and Last Name*

Are you a Turkey Hill Dairy employee?*

YesNo

If yes, what is your Turkey Hill ID Badge Number?

Phone*

Email*

Address 1*

Address 2

City*

State* -- SELECT YOUR STATE --ALABAMAALASKAARIZONAARKANSASCALIFORNIACOLORADOCONNECTICUTDELAWAREDISTRICT OF COLUMBIAFLORIDAGEORGIAHAWAIIIDAHOILLINOISINDIANAIOWAKANSASKENTUCKYLOUISIANAMAINEMARYLANDMASSACHUSETTSMICHIGANMINNESOTAMISSISSIPPIMISSOURIMONTANANEBRASKANEVADANEW HAMPSHIRENEW JERSEYNEW MEXICONEW YORKNORTH CAROLINANORTH DAKOTAOHIOOKLAHOMAOREGONPENNSYLVANIARHODE ISLANDSOUTH CAROLINASOUTH DAKOTATENNESSEETEXASUTAHVERMONTVIRGINIAWASHINGTONWEST VIRGINIAWISCONSINWYOMING

Zip*

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