Y Donation Request
Please fill out this form 2 weeks prior to your event. If available, please provide flyer or letter outlining the details of your event to give us a better idea of the type of donation that will fit you best.
Name of Organization
Name of Event
Date of Event
Tell us a little bit about your event and how our donation will help make your event a success:
How would you like to receive your donation if your request is fulfilled?
Pick up at the Janesville YMCA
Pick up at the Parker YMCA
If mail, please provide mailing address:
Should be Empty:
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