Donation Request
Please fill out and submit one donation request per event. Submission does not guarantee donation or response from 49 Degrees North Staff. Event must be ONE MONTH from submission date to qualify.
Email address *
Organization Name *
Your answer
Name *
Your answer
Title *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Phone Number *
Your answer
Fax Number
Your answer
Date of Event *
MM
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DD
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YYYY
Event Description *
Your answer
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