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Donation Requests
Please Complete Our Application Below:
Today's Date*
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First Name
Last Name
Phone Number
Email Address
Organization Name
Organization Address: Street, City, State, Zip
EIN/Tax ID#
501 (c) Status (since)
Program or Event Name
Reason for Request
Event Date*
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How will the funds raised be used?
Estimated Number of People Served?
Area/Community the program will serve
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