Community Donation Request
Click "submit" when completed.
Name
*
First Name
Last Name
Email
*
example@example.com
What Schupan business unit & location is making this request?
*
example: SIRS, Elkhart
Recipient/event name
*
example: BBBS Fire & Ice Ball
Date of event (if applicable)
-
Month
-
Day
Year
Date Picker Icon
Due Date of Check
*
-
Month
-
Day
Year
Date Picker Icon
Name of contact person at charity
First Name
Last Name
Send check to:
*
Charity
Street Address
City
State / Province
Postal / Zip Code
Phone Number of Contact Person at Charity
*
Please enter a valid phone number.
Does this sponsorship include any in-kind services?
Please Select
Yes
No
What, if any, additional marketing materials are needed?
Logo for digital use (website, presentation, etc)
Logo for print use (flyers, t-shirts, etc)
Company profile
Type option 4
Do you need branded promotional items as part of this request?
Please Select
Yes
No
Amount of donation/sponsorship
*
ex: $250
Brief description of recipient's purpose.
example: fundraiser for Breast Cancer Awareness
Submit
Should be Empty: