Atomic Provisions Donation Request Form

Atomic Provisions Donation Request Form
Thank you for thinking of Atomic Provisions for a donation to your non-profit organization! We are excited for the opportunity to work with your team and help make a difference in the community!

To be considered for a charitable donation, please complete the form below!

Donation requests are reviewed on a bi-weekly basis. You will recieve an email notification to let you know if you have been approved for a donation or declined. Hang tight and keep an eye on your email for updates!

While we'd love to help everyone, unfortunately there are times when we do need to respectfully decline requests. To stay within our communities, and our company mission and values, we donate to non-profit organizations within a 5-mile radius around each restaurant.

Donation Receipts: upon recieving a donation from Atomic Provisions, we do require your organization to submit a donation receipt for the total amount of goods provided. You may supply your own letter or use our template. Instructions will be provided.

Questions? Email Us! giving@atomicprovisions.com
Organization Name: *
Mailing address:*
Address line 2: (if needed)
City:*
State:*
Zip code:*
Contact Person
First name:*
Last name:*
Phone number:*
Email:*
example@example.com
Description of Non-Profit Organization:*
Requested item or amount (Gift Card, Food, Space, etc): *
Where and when will the event take place?*
How do you think this donation will benefit the community?*
Is your organization a non-profit or public tax-exempt organization as defined under Section 501(c)(3) of the Internal Revenue Code?*

YesNo
501c3 Tax ID #:*
When do you need to receive the donation? Please Note: Requests that received at least 2 weeks in advance are more likely to get approved.*

MonthDayYear
Date
Which Atomic location does your organization connect with most?
Upload Your Official Donation Letter (if applicable)

Cancelof
Acknowledgement of Donation Receipt*

I acknowledge and understand that upon receiving a donation from Atomic Provisions, I will need to provide an official donation receipt to the Donations team for the goods & Services provided.
Digital Signature*
First & Last Name
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If this donation will be supporting an event, feel free to tag us so we can repost! If you are able to send us any photos of follow up after the event, we would be happy to share that on our social media channels.
Instagram Handle
Facebook
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Atomic Provisions Donation Request Form

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