Application Form

Organization Information
(i.e., Group holding Fundraiser)
Organization Name*
Organization Address*
Street Address Address Line 2 City State ZIP Code
Organization State Sales Tax ID # (if any)
A copy of your state Sales & Use Tax Exemption Certificate is required prior to purchase.
Type of Organization*
- Educational
- Religious
- Community
- Charitable
Upload Tax Documentation
Contact Information
Name*
First Last
Affiliation with Organization/Title*
Daytime Phone Number*
Cell Phone Number
Email*
Signature
I certify that I represent the Organization applying to purchase Innisbrook products, that I have read the accompanying Qualifying Requirements and we meet the guidelines as stated.
Signature*
Date*
Date Format: MM slash DD slash YYYY

Organization Information