Organization Name:
Year Established:
Tax ID:
Name (CEO, or executive director):
Business of Your Organization:
Address
Website
Email
Phone
Requestor Contact Information (if different than above)
Name
Address
Phone
Email
Organization Event Details
Event Name
Event Location:
Event Sponsor/Underwriter:
Event Date:
MM
/
DD
/
YYYY
Number of Attendees:
Up to 25
26-50
51-75
76-100
101-151
151-200
201-250
251-300
301-350+
Up to 25
Describe marketing considerations such as program advertisement, database, onsite promotion etc.:
Item donated will be used for:
Live Auction
Door Prize
Silent Auction
Other
Referred By:
Comments
Please Note
Submission of this request does not guarantee that your request will be fulfilled. Status of requests will not be given or received over the telephone. This request system has been implemented to decrease our carbon footprint and to help protect our environment.
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