In-kind Donation Request

Dieffenbach’s strongly believes in supporting non-profit and charity events that benefit our local communities. If you would like Dieffenbach’s to consider your non-profit or charitable organization for a donation or a discount on our products, please review the information and complete the form below:

We require a minimum of 4 weeks advance notice to consider all requests.
One request per organization will be accepted within a 6 month period.
Please anticipate an e-mail response within 7 - 10 business days with a decision either way.

At this time, we only consider donations to organizations/groups that pick up product directly from our Womelsdorf, Pennsylvania facility.

We value the compliment you have given to Dieffenbach’s and will do our best to respond in a timely manner.

Available for pickup? *	Yes I can pickup at Womelsdorf location No
Event Name *
Event Type
Organization *
Email *
Comments *
Date of Event *
Location of Event *

Have we donated to this event in the past? *	Yes No
If yes, please provide date of previous donation
Non-profit, please provide your 501(c)(3)
Estimated number of people attending
What type of donation are you looking for? *
How will you recognize / promote our support for this event?

Full Name *
Phone *
Email *
Address *
City *
State *
Zip *
Questions/Comments
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