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Donation Request Form

Please read the guidelines before completing and submitting this form.

SECTION 1: General Information
First Name
Middle Initial
Last name
Phone Number
Email Address
Donation Requested Amount
Date Donation Requested

Organization Category: (choose one)
Accredited Education Institution College or university Secondary school Primary school Other	Other Institutions Arts and cultural organizations Nonprofit Community and civic Health and welfare Social service Other

SECTION 2: For the Organization Receiving the Gift
Name of Organization
Tax ID
Address
Phone Number
Email Address
Web Address

SECTION 3: Purpose of Donation

Please provide a summary of what the donation would be used for, include additional documents as needed. (At the discretion of the board, you may be asked to submit a formal proposal, including a presentation).