Java Joes Fundraising Program

JAVA JOES FUNDRAISING PROGRAM-Confirmation Form

Get started today! Complete and fax or email back to us:

fax: (631) 821-2736 | email:

Organization Name: ______

Chairperson: First: ______Middle Initial:______Last:______

Chairperson Signature: ______(signature on second page also required)

Phone: (______) ______Organizers E-mail: ______

Additional Contact: ______Phone: (______)______

Ship To: ______

Street: ______

City: ______State: ______Zip Code: ______

Which Java Joes Sales Consultant assisted you? ______Fundraising Goal: $______

Start Date: ______Finish Date: ______Delivery Date Needed: ______(Please allow 3 weeks for delivery)

(Please notify us if your dates change for any reason.)(Rush Fee may be incurred if order placed less than 2 weeks before delivery date.)

# of participants: ______(this is the # of order forms that we'll ship to you via USPS Priority Mail. Est. arrival is 3-4 days).

When would you like to receive your sales materials?______

Would you like your own online store with your own domain name to take orders online (set up takes 10 days)? YES or NO

Please choose your COFFEE program:____ $10.75 / 25-cup - profit $3.75 per unit

(Check only ONE)____ $13.75 / 40-cup - profit $5.00 per unit

____ $15.95 / 60-cup – profit $5.50 per unit ( Java Grande)

(Specialty beverages are included in all programs, sell for $13.75, profit $5.00 per unit and are packaged in black bags). *********************************************************************************************

*********************************************************************************************

Do you need a completed W-9 to release payment? Yes______No ______

Shipping/Delivery:

YES! Our organization would like to participate in Java Joes Fundraising Program. We understand that we will be shipped all necessary materials to conduct the fundraiser and that our representative will be available to assist the organization throughout this event. Organization must attach their own cover letter or the one we provide to our glossy color order form before distribution.

Organization will be responsible for the accuracy of total orders placed. All orders shall be placed on our online order system You will be given a password to log on after the fundraiser is over. Shipping is free! There is a $20.00 processing fee on all initial orders and $8 for all additional orders.

We understand that all product orders solicited are to be collected at the time of ordering and payment will be made to Java Joes Fundraising prior to receiving the order. All customer checks are to be made out to your organization when your fundraiser is running. Personal checks will not be accepted as payment. Payment for your order can be made by credit card, money order, school P.O., or business check.

All checks/P.O.'s can be mailed to 23 Magnolia Drive, Rocky Point, NY 11778. U.S. School Districts may pay their orders two weeks after they take delivery. All other organizations, orders must be paid in full to Java Joes Fundraising prior to orders being shipped. (Orders will be delivered within 2 weeks after payment is received and processed.) Orders will be shipped in alphabetical order by coffee flavor for easy handout to families.

In the event your fundraiser does not take place, all sales materials must be shipped back to Java Joes Fundraising or a cancellation fee of $35 will be incurred.

Please allow at least ten (10) days from submittal and receipt of this Confirmation Form for processing and delivery of your fundraising materials to start your fundraiser. Campaign packets will be mailed by USPS Priority Mail.

Confirmation Form must be emailed or faxed to your assigned representative

National Home Office Michael De Luca

Toll-free: (877) 341-2332 Fax: (631) 821-2736

e-mail:

You will receive a phone call or email upon receipt to verify information.

Referral Program

Any organizer that refers another school or organization that participates with us

will receive a FREE large bag of coffee in their choice of flavor.

Name______

Organization ______

Phone______

Email ______