50/50 Donation Request Form
Let us help you raise funds with our gifts.
Please complete and submit the form and email us a copy of your 501c3 and event flyer for processing.

We must have the 501c3 form in order to validate your request.

Should you require further assistance, feel free to call or an email us!

*Note: This is a preliminary order form. An invoice will be sent with order total for payment submission.

Payment must be made in full for all orders prior to processing.

Donation Request Info
Organization Name *
Your answer
Organization Website *
Your answer
Contact Name *
Your answer
Phone Number *
Your answer
Email Address *
Your answer
Your Cost *
Basket Theme *
Date Needed By *
MM
/
DD
/
YYYY
Quantity *
Your answer
Enclosure Card Message
Your answer
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