Care - Non-profit Request Form
If you are a Moses Lake, WA non-profit or service organization in need of assistance to fulfill your mission to help those in our community let us know! Please request items 30 days in advance of an event or specific date. We will reply back if we are able or not able to assist you. Thanks for all you do for our community! Care Moses Lake GIVES BACK to local Moses Lake Non-Profits only and not individuals directly. If you are an individual in need of assistance please check out our resources page: www.caremoseslake.com/resources/
Name of non-profit organization:
*
Are you a 501(c)(3)
*
Yes
No
Contact Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
What is your need or project you need assistance with? Please be as specific as possible.
*
Is there a dollar amount or value for the donation?
*
What date are items needed?
*
Submit
Should be Empty: