MADD Partnership Inquiry Form
Type of Opportunity
Please select...
Cause Marketing/Promotional Initiative
National Walk like MADD event sponsorship
Corporate Donation
Employee Fundraising
Employee Volunteering
In-Kind donations
Foundations
Workplace Giving
Other
First Name
Last Name
Title
Email
Company Name
Company Website
Phone
Company Street Address
Company City
Company State
Please select...
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Company Zip Code
Industry Type
Please select...
Alcohol/Spirits
Automotive
Agency
Cannabis/CBD
Communications
Consultant
Consumer Packaged Goods
Distribution
Emerging Technology
Energy
Financial Services
Food Service
Healthcare/Medical
Industrials
Manufacturing
Marketing/Communications
Nonprofit Organization/NGO
Packaging
Petroleum
Pharmaceuticals
Religion
Retail
Sports
Technology
Telecommunications
Travel
Other
If Other, please describe:
How long have you been in business?
Involvement with MADD Mission Delivery State Affiliates (Using the list below, please select all the MADD local offices you currently work with. If you don't have an existing partnership, please select "No existing partnership".)
Please select...
60100-0000 - AL State
60202-0000 - AK Fairbanks
60400-0000 - AZ State
60402-0000 - AZ Southern
60500-0000 - AR State
60600-0000 - CA Northern Sacramento
60604-0000 - CA Kern County Office
60610-0000 - CA Central Valley
60611-0000 - CA Southern California Affiliate
60612-0000 - CA Inland Empire
60614-0000 - CA San Diego
60620-0000 - CA Tri-Counties
60639-0000 - CA Northern Bay Area
60800-0000 - CO State
60900-0000 - CT State
61002-0000 - DE Chapter
61102-0000 - DC Office
61200-0000 - FL State
61204-0000 - FL South
61207-0000 - FL Central Florida Affiliate
61223-0000 - FL Northwest
61240-0000 - FL Southwest
61244-0000 - FL West Central
61251-0000 - FL Northeast
61300-0000 - GA State
61400-0000 - PR Puerto Rico
61505-0000 - HI State
61600-0000 - ID State
61700-0000 - IL State
61800-0000 - IN State
61906-0000 - Iowa
62000-0000 - Kansas
62100-0000 - KY State
62200-0000 - LA State
62302-0000 - ME Chapter
62400-0000 - MD State
62500-0000 - MA State
62600-0000 - MI State
62700-0000 - MN State
62800-0000 - MS State
62900-0000 - MO Central
62912-0000 - MO State Gateway
62922-0000 - MO Boone County
62928-0000 - MO Heartland
62929-0000 - MO Newton and Jasper County
62930-0000 - MO Ozark Mountain
63003-0000 - MT Chapter
63100-0000 - NE State
63203-0000 - NV Lyon
63302-0000 - NH Chapter
63400-0000 - NJ State
63500-0000 - NM State
63622-0000 - NY State
63700-0000 - NC State
63806-0000 - ND Chapter
63900-0000 - OH State
64000-0000 - OK State
64124-0000 - OR State
64200-0000 - PA State
64400-0000 - RI State
64500-0000 - SC State
64601-0000 - SD Chapter
64700-0000 - TN State
64800-0000 - TX State
64809-0000 - TX North
64811-0000 - TX West
64814-0000 - TX SE Texas Affiliate
64815-0000 - TX Bryan
64817-0000 - TX Beaumont
64842-0000 - TX South
64843-0000 - TX Edinburg
64853-0000 - TX East
64901-0000 - UT Chapter
65002-0000 - VT Chapter
65100-0000 - VA State
65300-0000 - WA Chapter
65448-0000 - WV State
65500-0000 - WI State
65605-0000 - WY Chapter
National Office
No existing partnership
Please describe your proposal below (Optional)