Dine & Donate Fundraiser Request Form Survey

Thank you for choosing Black Bear Diner for your next fundraiser.

Things to Know

The diners listed below participate in this program. If you do not see your preferred diner here, please contact them directly.
Events are held on Mondays, Tuesdays, and Wednesdays, from open to close of business with no more than one event per six months per organization.
Guests must show or provide the promotional code assigned to your event to apply their check to your fundraiser.
We agree to donate 20% of pre-tax sales per guest check associated with your organization's promotional code from your scheduled event time. This includes sales from dine in and online orders placed through BlackBearDiner.com.
We will provide a reproduceable promotional flyer with a promotional code and social media graphic approximately three weeks before your event.
We will share your event on our local Facebook page the day of your event.

Partnership Agreement
You agree to promote your event using the materials we provide through your own newsletters, social media accounts and other available channels. The more you promote, the more you will earn.

Please complete and submit this form thirty (30) days before your preferred event date.

1.At which diner would you like to hold your event?

2.Have we partnered with you for a previous Dine & Donate night?

3.If yes, was your last event over six months ago?

4.When would you like to hold your event? Please give us three options that could work for you.(Required.)

Day

Month

Date

1.

2.

3.

We schedule fundraising events for one full day per organization on Mondays, Tuesdays, and Wednesdays, from open to close of business with no more than one event per six months per organization. Note: Selecting these dates does not guarantee the date. We will contact you when we secure the date with the diner.

5.How would you like the name of your group to appear on the promotional flyers?

6.Does your organization have a Facebook Page?
If so, what is the Page Name? (We will use this to post and tag your event from our Page.)

7.Please tell us about you and your organization.(Required.)

Event contact name (person)

Organization name (to whom the check will be made payable)

Street Address (where check will be mailed)

Address 2

City/Town

State/Province

ZIP/Postal Code

Organization website address

Contact Email Address

Contact Phone Number

8.Is your organization set up as a tax-exempt 501(c)3?

If yes, please provide your TAX ID#

9.Briefly describe why your organization is trying to raise money. Include who or what it will support.

10.How many guests might we expect from your group? Please estimate.

Thank you. We will be in touch with you by email within two weeks. If you have questions, please contact our Outreach Marketing department or call 530.243.2327.

While you wait, be sure to join our eClub for a FREE meal when you join and another on our birthday!
Be sure to click the DONE button below to submit this form.

11.Did a team member refer you to this fundraising program? If so, we'd like to recognize them. Please provide their name.