Corporate Partner Application

Since Responsibility.org’s inception, drunk driving fatalities have decreased 31% and lifetime alcohol consumption among our nation’s youth has decreased 48%. But, there is much more work to do and progress to make. That’s where you come in.

As a Corporate Partner, you further underscore your enterprise’s commitment to and leadership in making our nation’s communities, roads and drinking behaviors more responsible by supporting initiatives like those herein. Learn more about this program and apply to become a Corporate Partner below.

Company Name*

Hereby makes an application to join Responsibility.org as a Corporate Partner. Once such application is approved by the foundation’s Board of Directors, a Corporate Partner is considered a partner in good standing by abiding by all applicable federal, state and local laws and ordinances; by paying such dues as may be assessed annually.

Applicant Name*

Applicant Title

Company Profile*

Street Address Address Line 2 City State ZIP Code

Telephone*

Fax

Website

How do you want your company name to appear for public purposes?

Name and contact information of principal corporate officer:

Name*

Title

Email*

Mobile

Is applicant incorporated in the U.S.?

Yes
No

If so, in what state?

Desired Partnership Level*

Responsibility Champion: $25,000
Corporate Patron: $10,000
Corporate Supporter: $2,500

See page 4 of the membership brochure for specific details.

Additional Employees

Name

Title

Email

Phone

Prevent Underage Drinking

End Drunk Driving

Drink Responsibly

Alcohol Statistics

Who We Are

Corporate Partner Application

Name and contact information of principal corporate officer: