Flyer / Information Distribution Verification

Please submit this form along with a copy of the flyer/information you wish to distribute and verification of 501(c)3 non-profit status to the San Juan Unified School District Family and Community Engagement office. You will receive a written response to your request within 15 business days. Do NOT distribute any materials to school sites until you receive written authorization to do so.

Name of Organization*

Organization Status *

Non-ProfitGovernment AgencyCommunity Service Organization

Non-profit organizations must provide an employer identification number (EIN) or taxpayer identificaiton number. The number provided must be for the organization submitting the flyer request and must appear in the IRS's tax exempt organizations, Publication 78.

If your non-profit organization is not listed in IRS Publication 78 or names do not match for some reason you may attach supporting evidence of your non-profit status which will be evaluated on a case-by-case basis.

EIN/TIN

Submit your 501(c)3 status information, if necessary.

Upload a File

Local service organizations must be non-profit in nature, have a mission to provide charitable service and benefits to local communities, have been active in the local community for at least five years and be members in good standing of an established state or national parent organization. This category typically includes groups like Kiwanis, Elks, Rotaries, Lions etc. Verification of the organizations status and mission may be requested.

Organizations that primarily provide classes or services for a fee of any type do not qualify as a local service organization and must be verifiable 501 (c) 3, supplemental education service providers as described above or a government agency in order to distribute materials.

Contact Name*

First NameLast Name

Contact Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Contact Email*

Contact Phone*

Area CodePhone Number

Contact Fax

Do you plan to distribute your information to all schools?

YesNo

If you marked “No” above, please provide a listing of which schools you will send materials.

When would you like your information distributed to students/staff?

Acknowledgement*

Yes I acknowledge that I have received and read a copy of Requirement for Flyers/Information

I have received and read a copy of Requirements for Flyers/Information.

Does your flyer / information apply to both boys and girls?

YesNo

If you checked No – Have you included contact information for organizations serving the other gender?

YesNo

Does your flyer, the information on your flyer, or the event/activity described on the flier promote any political or religious beliefs or actions?*

YesNo

Attach electronic copy of your flyer. *

Upload a File

Enter the message as it's shown.*

By submitting this information you certify that you are authorized to act on behalf of a government agency or non-profit organization in requesting distribution of information within San Juan Unified and understand that each school principal reserves the right to refuse flyers based on available staff time or individual school situations.