Survey

OPERATION FEED CAMPAIGN REGISTRATION (2012)

Yes, we want to join Mid-Ohio Foodbank in the fight against hunger next spring by participating in the 2012 Operation Feed Campaign!

Sponsoring Organization

Sponsoring Organization Organization Name (as it should appear in recognition):
Address:
Address 2:
City/Town:
State:
ZIP:

Type of Organization


Please select one.	Type of Organization Please select one.

Industry / Sector

Industry / Sector

Number of Employees or Members (for goal-setting and per capita awards)

Number of Employees or Members (for goal-setting and per capita awards)

Campaign Coordinator Information

Campaign Coordinator Information First Name:
Last Name:
Email Address:
Phone Number:

Campaign Time Frame (approximate--campaign runs March through June)

	MM		DD		YYYY
Start Date	Campaign Time Frame (approximate--campaign runs March through June) Start Date Month	/	Day	/	Year
End Date	End Date Month	/	Day	/	Year

Communications / Social Media Contact Information (to help us highlight your organization's philanthropic involvement)

Communications / Social Media Contact Information (to help us highlight your organization's philanthropic involvement) Communications Contact (First Name):
Communications Contact (Last Name):
Communications Contact (Email):
Organizational Web Page URL:
Organizational Twitter Handle:
Organizational Facebook Page Address:

President, CEO or Top Local Official (for leadership events, recognition)

President, CEO or Top Local Official (for leadership events, recognition) Prefix
First Name
Last Name
Title
Email

Communications and Outreach Options

	Yes
I am coordinating a campaign for the first time -- please have a campaign representative contact me with additional information.	Communications and Outreach Options I am coordinating a campaign for the first time -- please have a campaign representative contact me with additional information. Yes
I'd like to schedule my group for a tour of Mid-Ohio Foodbank or have an Operation Feed representative visit our meeting/campaign event.	I'd like to schedule my group for a tour of Mid-Ohio Foodbank or have an Operation Feed representative visit our meeting/campaign event. Yes
I'm interested in sharing my Operation Feed experience by mentoring a new campaign and/or attending an event on behalf of Mid-Ohio Foodbank.	I'm interested in sharing my Operation Feed experience by mentoring a new campaign and/or attending an event on behalf of Mid-Ohio Foodbank. Yes
I am willing to help recruit organizations in my industry to join Operation Feed.	I am willing to help recruit organizations in my industry to join Operation Feed. Yes

Please add these committee members to the Operation Feed email list:

Please add these committee members to the Operation Feed email list: Name I
Email I
Name II
Email II
Name III
Email III

Please contact the following organizations to discuss participation in Operation Feed (enter names and contact information).

Please contact the following organizations to discuss participation in Operation Feed (enter names and contact information).

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