Request an Event – Station Events

Phone

This field is for validation purposes and should be left unchanged.

Please complete and submit the online form below to request assistance in planning and executing a county station event. Station event requests must be submitted online. Paper forms will not be accepted.

For any questions regarding fuel station events, please contact your District Field Manager

County Organization*

County Contact Name*

First Last

County Contact Email*

County Contact Phone*

Station Name*

Station Address*

Street Address City State ZIP Code

Station Contact Name*

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Station Contact Name*

First Last

Station Contact Phone*

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Station Contact Email

Preferred Event Date*

In order to mail postcards to area members, at least three weeks notice is required from the date this form is completed and submitted.

Start Time*

Station events are limited to two hours maximum. If a county is interested in hosting a station event longer than two hours, please contact your District Field Manager.

:

End Time*

(Maximum 2 hours after Start Time)

:

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Alternate Event Date

At least four weeks’ notice is required for all station event requests.

An alternate date entry is required for all station event submissions. If an alternate date is not an option for your station event (i.e. station event would occur in conjunction with a community days celebration or other special event), please be sure to make note of that in the comments section at the end of this online form.

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Start Time*

Station events are limited to two hours maximum. If a county is interested in hosting a station event longer than two hours, please contact your District Field Manager.

:

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End Time*

(Maximum 2 hours after Start Time)

:

Fuel Discounts*

Check all that apply

Please note, Twin Cities Road Crew will only staff ethanol-related fuel pumps. For assistance with biodiesel promotions, please contact your soybean representative.

E85 – Discount Offered Per Gallon*

E15 – Discount Offered Per Gallon*

E20 – Discount Offered Per Gallon*

E30 – Discount Offered Per Gallon*

E50 – Discount Offered Per Gallon*

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B20 – Discount Offered Per Gallon*

Maximum number of gallons allowed per vehicle*

Please enter a number less than or equal to 30.

Number of pump dispensers at station*

Please enter a number greater than or equal to 1.

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Photos of Station/Event Location

Why? Exterior photos and pump photos of the event location are useful during the planning process and in determining the number of staff needed to execute your event successfully.

Accepted file types: jpg, gif, png, pdf, Max. file size: 2 GB.

Posters: Please indicate quantity needed*

Event posters will be sent out 1 week prior to event

Ship the poster to:*

Station Address
Different Address

Posters Delivery Name*

First Last

Posters Delivery Address*

Street Address Address Line 2 City State ZIP Code

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News Release*

A news release about your station event will be written and distributed by American Lung Association staff to local media outlets in your area. Please list any specific media outlets you wish to be informed of your event. Please submit one media outlet per form field. To add additional media outlets, click the + sign to the right of the text box.

Are there plans to purchase radio ads to promote the event? Please provide details.*

Please provide any additional details related to the event

(i.e. in-store promotions, other event participants or attendees, local events to be aware of on the same day, unique set-up needs, etc.)

Terms and Conditions*

GUIDELINES TO FOLLOW AT YOUR COUNTY’S FUEL PROMOTION EVENT

The Minnesota Corn Growers Association thanks you for taking the time to host a promotion event raising awareness of ethanol-blended fuels. Efforts like these are vital in our mission to promote the usage of ethanol blended fuels such as E15 and E85.

To ensure each event is a success, we ask that you follow the below guidelines to create a productive environment for all involved:

• Be respectful of consumers’ fuel choices: While the goal of the event is to promote higher blends of ethanol such as E15 and E85, participants must always be respectful of the drivers’ choice at the pump. Our role is to share the benefits of ethanol-blended fuels, but ultimately it is up to the customer to choose.

• STOP misfueling: Asking customers to use a fuel that has not been approved for their vehicle is strictly prohibited. Doing so can result in a significant fine for the driver.

• Direct media to the best contact: Please refer any media requests prior to the event or at the event to your MCGA District Field Manager.

Thank you again for taking the time to build a brighter future for ethanol! Following these guidelines will create an environment that is productive for all involved.

By checking this box, you are agreeing to follow each guideline and recognize failure to do so could result in MCGA withdrawing its support from future events.
Download the terms and conditions PDF

I have read the attached terms and conditions document.