Contact Information

We appreciate you volunteering within our community. Please complete the form below in order to apply for a donation on behalf of a nonprofit organization. Please make sure someone who works for the nonprofit organization has registered the organization. The organization’s registration is required before your request can be processed.

If you should need assistance, please email us at Charitable.DonationsHelp@publix.com or contact us at 863-688-1188 ext. 54276. Our hours of operation are Monday-Friday, 8 a.m. - 5 p.m. Eastern Time.

* = Required field

Prefix

* First Name

Middle Name

* Last Name

Title

Please include area code with all phone numbers

* Phone

Phone Ext.

Alternate Phone

Alternate Phone Ext.

* Email

* Confirm Email

* Organization Applying on Behalf Of

* Organization Address

* Organization City

* Organization State

* County

* Organization Zip Code

Mailing address is the same as the physical address

* Organization Mailing Address

* Mailing City

* Mailing State

* Mailing Zip Code