Manual Application

What type of organization do you represent?*

501(c)(3)
Religious Institution
Public School
Government Agency

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.

By entering my initials, I agree that the information I have entered on this form is true and complete and that I agree to all Terms & Conditions of membership.*

Phone

This field is for validation purposes and should be left unchanged.