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DONATION REQUEST FORM
Organization Info
Organization Country:
Tax ID
Enter your 501(c)(3) Federal E.I.N., School ID, Canadian Charitable Registration Number, or your Governmental Identification Number
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Zip:
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Organization Name:
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Year Established:
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Organization Type
First Name:
(i.e. CEO, President, Executive Director, or Development Officer at the Organization)
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Last Name:
(i.e. CEO, President, Executive Director, or Development Officer at the Organization)
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Street:
(No PO boxes please)
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City:
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State:
Primary Email:
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Primary Phone:
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Mission Statement:
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Website:
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Requester Contact Information
First Name:
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Last Name:
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Email Address:
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Primary Phone:
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Cell/Other Phone:
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Title/Relationship to Organzation:
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Organization's Event Details
Event Name:
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Description:
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Event Date:
MM
/
DD
/
YYYY
Event Location:
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Number of Guests:
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Event Sponsor/Underwriter:
(if no event sponsor/underwriter, please enter N/A)
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Request Details
Item Requested:
Item donated will be used for:
Referred by:
Please enter the contact name of the person at this organization who requested you to submit your request. Leave blank if no one referred you.
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Comments:
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Address to where item should be mailed (If possible, please provide a commercial mailing address):
Address:
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City:
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State:
Zip:
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Country:
*Please Note*
Submission of this request does not guarantee that your request will be fulfilled.
To review the status of your request at any time, please login with your user name and password, which will be emailed to you shortly. Status of requests will not be received over the telephone.
This request system has been implemented to decrease our carbon footprint and to help protect our environment. We appreciate your support. Thank you.
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