New Organization Info

& Sales Deck Request

(schools, businesses, sport groups, etc.)

Use this form to provide CharityRx with pertinent Organization information and to request a customized Sales Deck for them.

*The customized Sales Deck would be for pitching the prescription discount program to a new Organization.

Organization Info
& Sales Deck Request Form

REQUESTING PERSON INFO:

Enter YOUR Name

Email (use your RepHub email, if applicable)

ORGANIZATION INFO:

Name of the Organization EXACTLY as it should appear on any materials:

Organization's Website URL:

Organization's Address:

Street Address- Corporate headquarters, or main location (if multiple)

City

State

Postal / Zip code

Attach the Organizations logo here. Please try to attach a large, high quality version of the logo.

Preferred logo file formats: (in order of preference) eps, pdf, svg, png, jpg

Upload Logo (Version 1)

Preferred logo file formats: (in order of preference) eps, pdf, svg, png, jpg

Upload Logo (Version 2)

Please add Organization's corporate brand colors, if known. These are the color CODES to match their exact brand colors. Preferred: HEX # Accepted: CMYK, RGB, or Pantone If not known, we can typically get them from the colors used on their website and logo.

ORGANIZATION CONTACT PERSON:

First and Last Name

Title

Phone

SALES DECK INFO:

Would you like to customize the sales deck with the organization's name, logo, and colors?

Yes, please help me customize a Sales Deck.

No, I'll use the generic Sales Deck.

Preferred deadline for Sales Deck completion:

Do you have any special requests for your customized Sales Deck?

Any other comments or questions?

New Organization Info

& Sales Deck Request

(schools, businesses, sport groups, etc.)

Organization Info
& Sales Deck Request Form

REQUESTING PERSON INFO:

ORGANIZATION INFO:

Organization's Address:

Attach the Organizations logo here. Please try to attach a large, high quality version of the logo.

ORGANIZATION CONTACT PERSON:

SALES DECK INFO:

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New Organization Info

& Sales Deck Request

(schools, businesses, sport groups, etc.)

Organization Info & Sales Deck Request Form

REQUESTING PERSON INFO:

ORGANIZATION INFO:

Organization's Address:

Attach the Organizations logo here. Please try to attach a large, high quality version of the logo.

ORGANIZATION CONTACT PERSON:

SALES DECK INFO:

Organization Info
& Sales Deck Request Form