Instructions:
Enter your organization
name
(keyword search is sufficient, example: "Waco" instead of "The Waco Foundation")
OR
Enter your organization
EIN
(do not include spaces or dashes, example: 123456789).
Click "Search"
Organization Registration
Organization Information
We appreciate the services your nonprofit organization provides to our community. Please complete the registration form below on behalf of your organization in order to apply for a donation, grant or sponsorship.
If you should need assistance with your registration, please contact us at 863-688-1188 ext. 54276, or email us at CharitableDonationsHelp@publix.com. Our hours of operation are Monday - Friday, 8 a.m. - 5 p.m. Eastern Time.
* = Required field
Search IRS Database
Submission failed due to the following:
If you are a Church or other place of worship or a Public School please select No when asked if you have a registered EIN number. Enter your organization name in the Organization Legal Name field.
*
Does your organization have an EIN registered with the IRS?
--Select One--
Yes
No
Click the Search IRS Database button below to find your organization
EIN
Sales Tax Exemption Number
Please do not use abbreviations in the Organization Legal Name
*
Organization Legal Name
Foundation Code
Foundation Type
Subsection
If you are a Church and your organization has a parent organization please enter their name in the Doing Business As field (Examples: Florida Baptist Convention, Catholic Diocese, Evangelical Presbyterian, Protestant Episcopal Church in the USA).
Doing Business As
*
Please select which of the options below is applicable to your organization
Chamber of Commerce
Civic Organization (Rotary, Kiwanis)
School
Youth Sports
Other
*
Grade Levels
(ex K-5, 9-12)
*
Number of Students
*
School Type
Public
Private
*
Organization Mission
*
Address
Address 2
*
City
*
State
--- Select One ---
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Micronesia
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Marianas
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
County
*
Zip
Mailing address is the same as the address above
Please enter your organization's mailing address, not your personal home address
*
Mailing Address
Mailing Address 2
*
Mailing City
*
Mailing State
--Select One--
Alaska
Alabama
Arkansas
Arizona
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
Mississippi
Montana
North Carolina
North Dakota
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Virgin Islands
Vermont
Washington
Wisconsin
West Virginia
Wyoming
*
Mailing Zip
Please include area code with all phone numbers
*
Organization Phone
Fax
Please enter your organization's general email address, not your personal email address
Organization Email Address
Organization Web Site
Social Media Platforms and URLs (Facebook, Twitter, Instagram)
*
Does your organization have a social media platform?
--Select One--
Yes
No
Facebook
Twitter
Instagram
Contact Information
Prefix
Dr.
Mr.
Mrs.
Ms.
Miss
*
First Name
Middle Name
*
Last Name
Title
--Select One--
Board Member
Paid or unpaid employee
Volunteer (Team parent, PTA, PTO, etc.)
Committee Chair
Title
Please include area code with all phone numbers
*
Phone
Phone Ext.
Alternate Phone
Alternate Phone Ext.
*
Email
*
Confirm Email