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School or Organization:

Name:
Address:
City, State Zip:        
Phone: /       -          ext: 
Organization Type:
Federal Tax ID#: (See Note Below)
Principal or Director:
   
Fundraising Leader or Contact Person:
Name:
Email Address:
Phone: /       -      
   
Number of Community Partners Cards Needed:(500 max every 6 months)  
Closest Store to Your Organization:  
 Please note you may shop ANY participating Albertsons.
   
 
Qualifications: Any school (grades pre K‐12) or organization considered to be a 501(c)(3) non‐profit by the IRS.
 
NOTE *: We will require a copy of:
• Public Schools: Completed w-9 form
• Non-profit organizations IRS 501 (c) (3)Determination letter
    documenting your Non‐Profit status.

We can not review your application until the required documentaion is submitted.

* After hitting submit you will be provided with where to send any additional
    required documentation.
Customer Service: To speak with one of our fundraising expert call 1‐800‐696‐6419, Monday through Friday, 8:00 a.m. to 5:00 p.m. Eastern time.

PLEASE ALLOW 2‐3 WEEKS FOR PROCESSING
Albertsons LLC reserves the right to discontinue or change the terms of this program at any time.