Please print and fill out the form below so your organization will receive 10% of the sales purchased by your members. Email complete form to admin@givinggiftsthatgive.com or mail to Giving Gifts That Give, Inc., P.O. Box 268, Bradley, IL 60915.

Name of Organization:

Street Address:

City:

State:

Zip Code:

Telephone:

Alternate Telephone:

Name of Contact Person:

Website Address:

Email Address:

Make Checks Payable To:

Should the checks be mailed to the address above: Yes No

If no, please provide us with a mailing address for the checks below.

Street Address:

City:

State:

Zip Code:

How often do you want checks disbursed? Quarterly Annually

I, as an authorized representative of the organization stated above, authorize Giving Gifts That Give, Inc. to send checks in the amount of 10% of the sales from any member of my organization to the address above.

Signature: *

Printed Name:

* If sending form back via email please sign the signature line by printing your full name followed by “/s/”.

** This form allows Giving Gifts That Give, Inc. to do business with your organization. All rules are subject to change with prior notice.