Baja Fresh Fundraising Inquiry

539 Medford Ctr,

Medford OR 97504

Phone: (541) 245-8999

Please complete the form below to be contacted about fundraising for your organization. A store representative will be in touch with you as soon as possible.

*Indicates Required Fields

When?

Date availability varies by location.

^*Event Date/Time

Who?

^*Organization Name

^*Organization Type

^*Expected Number of Attendees

^*Contact Name

^*Contact Phone

^*Email Address

^*Tax ID #

^*How did you hear about us?

How

Your organization will receive a check for the amount raised, please let us know where to mail your donation.

^*Check Payable To

^*Attention To

^*Address

^*City

^*State

^*Zip/Postal Code

^*What will funds be used for, specifically?