Pantera Cares

Pantera Cares

Donation Request Form
Pantera Energy Company 817 S. Polk, Suite 201 Amarillo, TX 79101

Email: donationrequest@panteraenergy.com
Please fill out all the information on this submission form. This information is REQUIRED in order for us to donate any funds to your organization. Information MUST be complete to be considered.
Organization Name
EIN
Contact Name/Title
Billing address
City, State, Zip Code
Phone Number

Area CodePhone Number
Email
example@example.com
Fax
example@example.com
Requested Donation Amount:
What Year was your organization founded?
Briefly State Your Organization's Mission
Briefly Explain What the Funds Will Support
What is the service area for your organization (ex: Amarillo, Dumas, etc.)?
How many does your organization serve/year?
Is your organization classified as a 501(c)(3) by the IRS?

YesNo
Should be Empty: