Charity Application

This application allows your charitable organization to be eligible for Gift Card discounts from Piggly Wiggly. All organizations must be exempt under Section 501(c)3 of the Internal Revenue Code.
(*) Required
*Full Name Of Organization
501(c) Number
Street Address
*Contact Name
City
State
ZipCode
*Phone Number
 ()   - 
Fax Number
 ()   - 
Date Incorporated
 
Email Address
 
Web Address
 
Description of Organization and Services Provided
Submit