JAVA JOES FUNDRAISING PROGRAM

Organization Commitment Form

Organization Name: ______

Director/Chairperson Name: ______

Director/Chairperson Signature: ______

Phone: (____) ______

Organizers E-mail ______

Additional Contact: ______

Phone: (____) ______

Java Joe’s Fundraiser Sales Rep name must be filled out ______

Shipping/Delivery Address (No P.O. Boxes accepted) We would like a business address.

Print Clearly

Ship to:______

Street: ______

City: ______State: ______Zip Code: ______

Start Date: ______Finish Date: ______Custom Label: Yes______No______

For Free Custom Label on your coffee bags please email design or scan to Call for more details!

Please circle what program you want 40 cups @ .33 = 13.00 School keeps 5.00 per unit

or

Please circle what Program you want 11 cups for .63 = 7.00 School keeps 2.80 per unit

Please choose color bag for Regular Coffee:

(Circle one) Red Blue Green Silver Purple Maroon White Gold Cooper Black

Please choose color bag for Decaffeinated Coffee:

(Circle one) Red Blue Green Silver Purple Maroon White Gold Cooper Black

Anticipated # of participants: ______Fundraising Goal: $______

(This is needed so we know how many forms to print and to ship you)

If a completed W9 is needed to release payment please check here Yes______No ______

Shipping/Delivery:

YES! Our organization would like to participate in Java Joes Fundraising Program. We understand that we will be shipped all necessary materials to conduct the fundraiser and that our representative will be available to assist the organization throughout this event. Organization must attach their own cover letter to our Glossy color order form before distribution. Organization will be responsible for the accuracy of total orders placed. All orders shall be placed on our online order system You will be given a password to log on after the fundraiser is over.

We understand that all product orders solicited are to be collected at the time of ordering and payment will be made to Java Joes Fundraising prior to receiving the order. Personal checks will not be accepted. Payment for your order can be submitted by money order, school or business check mailed to 23 Magnolia Drive, Rocky Point, NY 11778. All customer checks are to be made out to your organization when your fundraiser is running. Orders must be paid in full to Java Joes Fundraising prior to orders being shipped. (Orders will be delivered within 2 weeks after payment is received and processed.) Orders will be shipped in alphabetical order by coffee flavor for easy handout to families.

Please allow at least two (2) weeks from submittal and receipt of this Commitment Form for processing and delivery of your fundraising materials to start your Fundraiser. Campaign packets will be mailed by Fed Ex or Us mail.

Commitment Form must be emailed or faxed to your assigned representative

or

National Home Sales Office

Phone 877 341 2332 Fax 631 821 2736 Email

You will receive a phone call or email upon receipt to verify information.

Our Referral Program

Any Organizer That Refers another School or Organization That participates with us

Will receive a free large bag of coffee of their choice

We are referring

Name______

Organization ______

Phone______

Email ______