Application for Funds for Local Communities
We are frequently approached by various organizations in the communities where our stores are located for funding local events or other sponsorships. If you have an event or sponsorship that you would like to be considered for funding, please complete the following form and submit it to us. We will review each submission and contact the organization with an answer promptly.Thank you for shopping at GasAmerica!
Name of Organization 
Street Address 
Address (cont.)
City 
State 
Zip/Postal Code 
Contact Person 
Daytime Phone Number   Ext  (please include area code)
E-mail 
Type of Organization 
Is the organization recognized as a 501(c)3? 
Description of Event or other Sponsorship:
Area(s) Covered (Cities, County): 
Timing of Event: 
Estimated number of people to be at event: 
Media promotion that will occur (Newspaper Ads, Radio, TV, etc.): 
Other promotions that will occur with event (flyers, etc.): 
Will there be an opportunity for GasAmerica’s logo to be displayed? 
Level of Commitment sought in dollars: 
Deadline for when you will need an answer: 

 

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