Smoky Hill Vineyards & Winery Donation Request Form

Online Wine Sales Application Form >

Smoky Hill Vineyards Donations Request Form

Please read the following information before submitting your request.

State and Federal laws prohibit the donation of wine products, unless the organization holds a 501C-3, other certificate of non-profit status, or is a political committee according to KSA 41-104, section H. Proof of that status will be required for the donation of wine products.

All requests must be submitted at least 30 days before the desired event date. This will allow us time to carefully review your request and get it to you in a timely fashion.

*FIELDS MARKED WITH ARE REQUIRED!**
First Name:*
Last Name:*
Business/Organization Name:*
Address:*
Address Cont.
City:*
State:*
Postal Code:*
Telephone:
E-Mail Address:
Event:*
Date of Event:*
Brief Description of Event:
Event Location:
Anticipated Attendance:
Are there marketing opportunities for Smoky Hill Vineyards & Winery?:

Will there be specific mention made of our support? (i.e., complimentary directory/brochure/sponsorship listings):

Has Smoky Hill Vineyards & Winery contributed to your organization before?:

If yes, please explain and skip the next 3 questions.:

Are there any Smoky Hill Vineyards & Winery employees involved in your organization/event? If so, please list:

Are you a Smoky Hill Vineyards & Winery customer?:

If yes, what are your favorite wines and/or events?:

MAILING ADDRESS FOR CERTIFICATE: (include “attention to” name)

Gift items other than certificates, must be picked up by the organization at one of our three locations. Certificates will be mailed.
When done, please or

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