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Bustard Chrysler Waterloo Donation Request Form
Name of Organization
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Organization website
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If applicable, tax registration or official designation number:
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Organization Range (Local, Regional, or National)
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Type of Organization
Name of Contact Person
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Title in Organization of Contact Person
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Phone Number of Contact Person
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Email of Contact Person
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Address
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Amount of Funds Requested
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Type of Relationship to us (e.g. purchased car, service, employee)
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Have you received funding from us before?
Will this be a one time donation or recurring payment?
If the donation will be used/related to a event please specify what event it is for
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What date does the donation need to be received by?
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What will the donation be used for? (in 100 words or less)
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How will we know the money has been used effectively? (in 200 words or less)
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How do you plan to acknowledge the dealership? (in 100 words or less)
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What sets your organization apart from similar organizations? (in 150 words or less)
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Please give examples of how you have used donation money in the past effectively?
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Please list any organizations who have donated to your organization in the past with a contact name, phone number, and email to be used as a reference. (preferred 3)
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