Donations

Organization Name:

Website:

Tax ID #:

Name & Title of Contact Person:

Phone Number:

(###)

###

####

Email:

Hosting organization if different from Charity:

Mailing Address:

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Event Name:

Event Date:

Donation request must be received at least 45 days prior to date of event

YYYY

Items to be used for...

Is your organization a 501(c)3 organization (non-profit)?

Yes

Is your organization a local chapter of a national charity?

Yes