Donation Request Form

Donation Application

As a member-owned Cooperative, CTC encourages active support of the community we serve by providing sponsorships and donations to tax-exempt, non-profit organizations and community groups. Please fill out the form completely and submit. A downloadable PDF version of the form is also available on our website.

Name of Organization/Event(s) *

ex. Cordova School District

Contact Email *

example@example.com

Contact Phone Number *

Area Code Phone Number

Date of Application *

Date

Date of Event(s) *

Date

Deadline for Response *

Date

Type of Event *

Organizational Fundraiser Community Event School Activity/Sport Charitable Cause

Type of Request (choose one) *

Cash Goods or Service

If cash, enter amount requested.

Amount Requested

If goods/service, please identify.

Type of Goods/Services Requested

Brief description of the organization or event and its benefit to the community. *

Tell us who you are and what you do.

If granted, how will the contribution be used? *

ex. Travel to state competition, Purchase t-shirts for event promotion, etc.

Are you a 501(c)(3) or (c)(6) organization? *

Yes No

If NO to above, give tax classification.

Tax classification

How will CTC/CWC be recognized for their donation/sponsorship? *

ex. Name printed on t-shirts, newspaper "thank you," etc.

Name of Board of Directors or Key Members of the Organization. *

ex. John Smith, Jane Doe, etc

Are you a CTC customer? *

Yes No

Are you a CWC paying plan customer? *

Yes No

Are you requesting a donation from... *

CTC CWC Both

How many years has CTC/CWC contributed to your organization/event and what have we contributed? *

ex. Cash donation, door prize items, etc

If you'd like to be added to our e-mail list, enter your preferred e-mail address here.

FOR INTERNAL USE ONLY

APPROVED ( ) YES ( ) NO

BY:_______________________

Send Where and When______________________________________

Request Filled By:___________________

Date:_________________

Items:___________________________________________________

________________________________________________________