THE GO GREEN LOCAL COMMUNITY ASSISTANCE PROGRAM

Nominate your favorite not-for-profit*. If we draw their name, they’ll receive a donation!

Every month, Go Green Express will make a donation to a not-for-profit within the community. Since we’ll be stopping at lots of places this year, we call our community donation outreach The Go Green Local.

Here’s how it works:

• Nominate your favorite not-for-profit on the form below.
• Tell your friends to nominate, too. The more nominations we receive, the better
  the chance that your favorite not-for-profit will be selected.
• We select the organization to receive the next “Whistle Stop” in a drawing on the
  15th of each month.
• Monthly donations will be posted on our web site, and on our Facebook and Twitter pages.
• You can track it in the local papers as well.

If your chosen not-for-profit wasn’t drawn, you can re-nominate them for the following month. You can only nominate once a month, but you can try again every month. Soon, The Go Green Local may do a “whistle stop” at their door and give them a well-deserved gift.

*Must be a 501C3 organization.

Please fill in all the indicated boxes. You must provide sufficient information to ensure we don’t have duplicates and that the nomination is authentic. We don’t want to disallow any nominations ...so make sure your form is filled in fully!

Your Name *
Your Email Address *
Home Phone
Work Phone
Address
Address 2
City
State
Zip Code
Organization you wish to nominate *
Organization Location:*
Organization Website
What makes this non-for-profit special? *
How did you hear about our community campaign?
* required