EmailMe Form - Donation Request Form

Organization Information

Employer Identification Number *

Enter your 501(c)(3) Federal E.I.N. Organizations must be a non-profit.

Organization Name *

Purpose of Organization *

(i.e. mission statement)

Name *

First Last

(i.e. CEO, President, Executive Director,
or Development Officer of the Organization)

Address *

Street Address City State / Province / Region Postal / Zip Code

Email Address *

Phone *

### - ### - ####

Website Address *

Contact Information

Please provide the contact name, email, phone and address where the donation should be mailed.

Contact Name *

First Last

Contact Address *

Street Address City State / Province / Region Postal / Zip Code

Contact Email Address *

Contact Phone *

### - ### - ####

Relationship to Organization *

Organization's Event Details

Event Name *

Event Date *

MM / DD / YYYY

Event Description *

Event Location *

Item donated will be used for? *

Silent Auction

Raffle

Door Prize

Other

Attach Documents

You may attach documents that describe your event, your 501(c)(3) letter or any other related document. Files will be uploaded when you click submit. Attachments must be in one of the following formats: Pdf, doc, docx, xls, xlsx, csv, jpg, jpeg, png. Limit the file size to less than 4MB.)

File Upload

Confirm and Submit

Confirmation *

I understand that submission of this request does not guarantee that my request will be fulfilled. Status of requests will not be available over the telephone.