Space Request Tool for a Local Tootsie Roll Drive

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Please list the name we should submit for the local council contact:
First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Email REQUIRED Please fill out this field. Please enter an email address.
Mobile Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
How does this event help your local organization meet a need in the community? REQUIRED
Please describe how this benefits your local community and where your council donates their share of the earnings.
Please fill out this field.
How will you engage with customers on Walmart's property? REQUIRED
Please describe how your council interacts with customers as they approach the entrance.
Please fill out this field.
Which Walmart would you like to request space at? Please include full address, including zip code REQUIRED Please fill out this field. Please enter valid data.
City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.
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Please list the specific dates and times you would like to request. Per Walmart requirements, requests must be made no less than 21 days in advance of the event date. If more than four dates are necessary, please submit a second form.
Day 1
- What is the first date you would like to request? REQUIRED Please fill out this field. Please enter a date.
- Which times would you like on day 1? Please note only these time slots are offered in the Space Request Tool. REQUIRED All day (10:00 am – 6:00 pm) Morning (8:00 am – 12:00 pm) Afternoon: (12:00 am – 4:00 pm) Evening (4:00 pm – 8:00 pm) Please fill out this field.
Day 2 (optional)
- What is the next date you would like to request? Please enter a date.
- Which times would you like to request on this day? All day (10:00 am – 6:00 pm) Morning (8:00 am – 12:00 pm) Afternoon: (12:00 am – 4:00 pm) Evening (4:00 pm – 8:00 pm)
Day 3 (optional)
- What is the next date you would like to request? Please enter a date.
- Which times would you like to request on this day? All day (10:00 am – 6:00 pm) Morning (8:00 am – 12:00 pm) Afternoon: (12:00 am – 4:00 pm) Evening (4:00 pm – 8:00 pm)
Day 4 (optional)
- What is the next date you would like to request? Please enter a date.
- Which times would you like to request on this day? All day (10:00 am – 6:00 pm) Morning (8:00 am – 12:00 pm) Afternoon: (12:00 am – 4:00 pm) Evening (4:00 pm – 8:00 pm)

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Knights of Columbus

Kansas State council

Space Request Tool for a Local Tootsie Roll Drive

Space Request Tool for a Local Tootsie Roll Drive