CHARITABLE DONATION REQUEST FORM

Organization must first meet the following requirements to be considered eligible:

  • The organization must qualify as a registered 501(c)3 nonprofit organization by the U.S. IRS
  • The request is not for a political or religious purpose.

Organization information:

Name:
Email Address:
Address:
City:
State:
Zip:
Phone No:


About the organization:

Tax Id#
Mission:
Geographical Area Served:
Organization’s website:
Programs and Activities:
Request:

Where funds will specifically be used for, and the expected benefits.

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