VFFA Proposal Submission Form

This form is to be used for all customer events/activities in which manufacturers will be funding, in whole or in part, the activity. This is not required for Sales Meetings or Synergy Partners Program activities.

If at any time you have questions regarding the VFFA program or process, please contact the VFFA program administrator by email at VFFA@mwiah.com.

After a successful submission of your VFFA request and its associated approvals, the VFFA program administrator may record the R# for this activity in the space below so that all records are retained together. You will also be notified of this R# by email.

SUBMITTER'S INFORMATION

First NameLast Name

Email

Sales Region

Area CodePhone Number

ELIGIBILITY ACKNOWLEDGEMENT

Are any of the accounts attending this activity or receiving this activity's benefit a federal, state or local government institution (universities, police academies, state-run shelters, etc...)?

According to the MWI VFFA policy, no recreational or entertainment events, gifts or other items of value may be offered or provided to any federal, state or local government employee. Similarly, vendor funded field activities may only be offered or provided to veterinary or animal health customers that are not covered by any federal or state insurance program.

Sponsoring Manufacturer

Other

Will this activity be branded with the Elanco brand?

Does this activity comply to all Elanco policies?

ACTIVITY DETAILS

Please Specify Activity Type

Activity Name

The activity name should reflect the legitimate business reason(s) for the engagement. Any entertainment should be secondary.

Activity location and name of third party provider of sponsored activity

Ex: name of the event venue or the provider of the service being sponsored

Speaker name

Will flights or hotel nights be needed?

Based on the projected number of associates and non-associates, please select from the following.

Specifically, list ALL items or services that will be purchased in association with this activity.

Activity description

Activity's purpose and desired benefit to the customer

Activity Agenda

Browse Files

Please upload a preliminary agenda for this activity. Agenda is required for any VFFA with a projected spend of $10,000+

Activity content: what % of this activity will be devoted to education or marketing services (versus entertainment)?

Activity Start Date

Date

Activity End Date

Date

Please note activity duration should not exceed 90 days. If you've indicated longer, please provide specific reasoning in the additional information comments box at the bottom of this form. Failure to comply may result in an R number not being issued.

ATTENDEES/RECIPIENTS

Indicate all MWI representatives associated with this activity. Enter a single name in the box. Click Add More to include additional attendees.

Indicate all Sponsoring Manufacturer representatives associated with this activity. Enter a single name in the box. Click Add More to include additional attendees.

Indicate all participating accounts in this activity. If you are uploading a file instead, please just type UPLOAD in the Acct Name field.

Indicate all participating accounts for this Elanco funded activity. If you are uploading a file instead, please just type UPLOAD in t he Acct Name field.

As an alternative to listing accounts above, please upload your attendance file here.

Browse Files

How many attendees will be participating in this activity?

* Number of end-users influenced applies only to activities such as the producer meetings, where we are partnering with one or more accounts to influence 40 (for example) local area producers.

SPEND AND PRODUCT DETAILS

Projected Spend

Select the range the above Projected Spend falls within

You must select a valid Projected Spend range in the previous question to continue (ie - range cannot be blank).

Select the species focus(es) associated with this activity.

Please identify the Focus Product(s) or Category(s) related to this activity.

APPROVALS

For activities with projected spend of less than $500.00, the following approval is required.

Manufacturer Approving Manager

Based on this requirement, please list the approver that will be associated with this activity.

For activities with projected spend between $500.00 and $2,499.99, the following approvals are required.

Manufacturer Approving Manager
MWI Sales Director