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interest form
Contributors
Donate Product
Vitamin A Specs
Multi Formulations
Labeling
Interest Form
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Product Contribution Interest Form.
THANK YOU
Thank you for your interest in donating product to our domestic and international projects. We are eager to have you join the Vitamin Angels family. Please complete and submit the following form and we will contact you shortly.
CONTACT INFO
Who should we contact regarding your product donation to Vitamin Angels?
Name:
*
Email:
*
Company:
*
Phone:
*
Address:
*
City:
*
State:
*
Zipcode:
*
Country:
*
Name of person filing out form:
if different from point person
PRODUCT
Which products are you interested in donating to Vitamin Angels?:
50,000 IU vitamin A
100,000 IU vitamin A
200,000 IU vitamin A
mebendazole
multivitamins for children
multivitamins for pregnant/lactating women
albendazole
other (please specify below)
We are open to receiving other products. Please include comments or request a consultation here.:
Is your donation a branded off-the-shelf product?:
Yes
No
Are you interested in producing vitamin A or multivitamins to Vitamin Angels’ specifications and/or formulations?:
Yes
No
(Please note: Vitamin Angels can only accept vitamin A that is produced to our specifications.)
Are you interested in working with us to create packaging or labels for your product contribution? :
Yes
No
Labeling and packaging developed specifically for Vitamin Angels broadens our ability to comply with international guidelines and to deploy your contribution to projects where it is most needed.
Vitamin Angels requests that all donors provide shipping to a US-based address. We also gratefully accept shipping to international project locations:
Domestic
International
Shipping is fully tax-deductible for US-based companies. Please check one or both of the above
Other Comments:
TAX RECEIPT
Please tell us to whom we should direct the tax receipt once your contribution has been received. (If different from main contact above)
Name:
Phone:
Company:
Address:
City:
State:
Zipcode:
Country:
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