Donation Request

Organization Name(*)

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Contact Name(*)

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Contact Email Address(*)

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Contact Phone Number(*)

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Address(*)

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City(*)

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State(*)

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Zip Code(*)

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Organization Website

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Where is your organization headquartered(*)

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What would you like us to donate?

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Tell us why you are requesting this donation(*)

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Event Date(*)

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Event Type(*)

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If Other, please indicate type of event

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About how many people will be attending(*)

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What is your fundraising goal for your event (auction proceeds, ticket sales, cash donations, etc.)?(*)

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Flyer or Brochure(*)

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validation

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