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Donation Request Form
Thank you for requesting a donation from Mainstream Boutique of Janesville. As a business that is committed to our community, we believe it’s important to support worthy organizations. *At least two weeks’ notice is required for consideration.
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* Indicates required question
Name of Organization or Group
*
Your answer
Contact Person
*
Your answer
Email
*
Your answer
Phone Number
*
Your answer
Are YOU a current customer of Mainstream Boutique Janesville?
*
Yes
No
Is this a Non-Profit Organization?
*
Yes
No
Tax ID Number:
Your answer
Purpose of the Fundraiser:
*
Your answer
Donation Being Requested:
*
Your answer
If cash or gift certificate, amount requested:
Your answer
Date of Fundraiser
MM
/
DD
/
YYYY
How many people will attend?
Your answer
Location of Fundraiser:
*
Your answer
Will the donated item be auctioned, raffled, or given away?:
*
Your answer
We need to have a commitment by:
*
MM
/
DD
/
YYYY
Donations need to be picked up by:
MM
/
DD
/
YYYY
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