OPERATION FEED CAMPAIGN REGISTRATION (March-June, 2017) Yes, we'll join Mid-Ohio Foodbank in the fight to end hunger by participating in the community-wide Operation Feed campaign! 1. Sponsoring Organization Organization Name (as it should appear in recognition): Address: Address 2: City/Town: State: -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP: 2. Type of Organization Please select one. Company (1-249 employees) Company (250-999 employees) Company (1000+ employees) Independent/Small Business Membership Association Nonprofit Organization Government Agency School/Educational Institution Civic Group Faith-Based Organization Other Please select one. menu 3. Industry / Sector 4. Number of Employees or Members (for goal-setting & awards) 5. Campaign Coordinator Information First Name: Last Name: Email Address: Phone Number: 6. Campaign Time Frame (approximate -- program runs March-June) Start Date MM / DD / YYYY End Date MM / DD / YYYY 7. 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: 8. President, CEO or Top Local Official (for leadership events, recognition) Prefix First Name Last Name Title Email 9. Communications & Outreach Options Yes I am coordinating a campaign for the first time. I am coordinating a campaign for the first time. Yes I'd like to schedule my group for a tour of Mid-Ohio Foodbank. I'd like to schedule my group for a tour of Mid-Ohio Foodbank. Yes Please contact me about scheduling an Operation Feed representative to visit our meeting/campaign event. Please contact me about scheduling an Operation Feed representative to visit our meeting/campaign event. Yes 10. Please add these committee members to the Operation Feed email list: Contact 1 - Name ----------------- Email Contact 2 - Name ----------------- Email Contact 3 - Name ----------------- Email 11. Please contact the following organizations to discuss participation in Operation Feed (enter names and contact information). Sign up for Operation Feed!