Heartland Cooperative Services
101 Parkside Dr. Dorchester, WI 54425
715-654-5134 or 1-800-521-2021
AGRICULTURE - INDUSTRY - RURAL LIVING
Please use the electronic submission form below.
Requests must be received a least one month in advance.
Requests are considered on a first come first serve basis
Contact Phone Number, (Include area code)
Monetary donation amount requested
Product(s) & quantity requested
Reason for request: I.E. What will the product or money be used for?
If this is for a event, state date and location
Provide brief description of event
Who should the check be written to?
If product needs to be delivered please provide location and time.
Organization or contact address
Requested donation is needed by what date?
All requests will be reviewed on a first come first served basis. Please submit request one month prior to event.
If you prefer to fill out the form by hand and mail it in please click here for a printable form.