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Donation Request Form
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* Indicates required question
Email
*
Your email
Name
*
Your answer
Title or Relationship to the Organization
*
Your answer
Phone Number
*
Your answer
Organization Name
*
Your answer
Organization Address
Your answer
Is this a For-profit or Nonprofit Organization?
*
For-profit
Nonprofit
Please enter your nonprofit 501(c)(3) EIN Number
Your answer
What is the mission of your organization?
*
Your answer
Has your organization received a donation from Third Eye in the past?
Yes
No
Clear selection
Event Name
*
Your answer
Event Date
MM
/
DD
/
YYYY
Event Description
*
Your answer
Event Location
Your answer
What are you requesting? *Please be specific. List items, quantities, sponsorship amount, etc. Ohio law prohibits any business from giving away beer or alcohol.
*
Your answer
Donation to be Used For:
Sponsorship
Live Auction Donation
Silent Auction Donation
Raffle Item Donation
Gift Bag Inclusion
Other (Please describe below)
Clear selection
If other was selected, please explain.
Your answer
Date Needed
*
MM
/
DD
/
YYYY
Submit
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