Manual Application

What type of organization do you represent?*

Organization's Name*

Please enter your organization's name

Organization's FEIN*

Please enter your organization's FEIN

Billing Information*

Street Address Address Line 2 City State ZIP Code

Billing Phone Number*

Shipping Information*

Street Address Address Line 2 City State ZIP Code

Shipping Phone Number*

Account Information*

First Name	Last Name	Phone

Email (this will be your username)*

Authorization & Acknowledgement*

Please check all boxes to verify eligibility

I am authorized to receive tax-deductible donations on behalf of my organization
I acknowledge to receive products only to benefit my non-profit organization.
I agree that I will not not resell, barter, or exchange merchandise –(whether at flea markets, thrift shops, auctions, raffles, charity benefits, fundraising events, or in any other context).
I understand that merchandise may not be given to or taken by volunteers, officers, clergy, or employees for personal use.
I agree to keep receipts for all transactions with WIN for a period of 2 years in the event the IRS wishes to verify these transactions.
I understand that all product WIN distributes has been donated and all donated merchandise is distributed ‘As Is’. Warranties are not valid on any donated item.

Please enter your initials to acknowledge that the information on this form is all true and completed to the best of your knowledge*