EDEN Banner Request Form

EDEN Banner Request Form

The information collected in this form will be used to request an EDEN banner for an event you are hosting or attending.

Please review the following terms of EDEN Banner usage:
- FADI-EDEN will cover the cost of shipping the banner to the address you provide
- You or your institution are responsible for covering the cost of shipping the banner back to the Extension Foundation OR to its next user.
- Use the form below to request a banner. Requests not received 6 weeks before your event may not be able to be fulfilled.
- If your request cannot be fulfilled, the FADI-EDEN support staff will follow up with you as soon as possible.
Name*

First NameLast Name
Office Phone*
Please enter a valid phone number.
Cell Phone*
Please enter a valid phone number.
Email*
example@example.com
Institution*
Address of the Event
Date of the event

MonthDayYear
Date
Address where the banner should be sent
Date you need to receive the banner

MonthDayYear
Date
Please confirm your acceptance of the statement below by signing
I acknowledge that I have received the promotional banner from [Company/Organization Name]. I accept full responsibility for the care and return of the banner. Furthermore, I understand that I am responsible for covering the cost of shipping the banner back to the Extension Foundation by the agreed-upon deadline.

Failure to return the banner in a timely manner or in acceptable condition may result in additional charges as determined by the Extension Foundation.
Signature

Clear
Name of the Event*
Please verify that you are human*
Should be Empty:

EDEN Banner Request Form

Please confirm your acceptance of the statement below by signing