Organization Name
*
Organization Tax ID
*
Organization Street Address
*
Street Address Line 2
City
*
State
*
Zip Code
*
Contact Person First Name
*
Contact Person Last Name
*
Phone
*
Email
*
example@example.com
Address for Donation to be sent, if different than Organization Address
Street Address Line 2
City
State
Zip Code
Name of Event
*
Date of Event
*
-
Month
-
Day
Year
What field is your organization part of?
*
Please Select
Arts & Humanities
Educational
Health and Human Services
Please attach a PDF of your donation request letter. All letters must contain the following:
Organization name
Contact information
Tax ID Number
Name and date of the event
Attach Letter
*
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