Donation Request

Donation Request

Donation Requests will be evaluated in relationship to our mission of serving the youth and families in our community. If you are requesting a contribution from Kiwanis Club of Atascadero, please note that these donations will be for those in the North County area of San Luis Obispo County.
Please complete this form at least 4-6 weeks in advance.
Date of Request*

MonthDayYear
Date
Name of Requestor*

First NameLast Name
Email*
example@example.com
Requestor's Phone Number*
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Name of Organization
Are you a non-profit?

YesNo
Dollar Amount Requested
Can you work with partial funding?

YesNo
Date of Project / Event:

MonthDayYear
Date
Date donation / funds needed:

MonthDayYear
Date
What are the goals of the program or project?
Objectives (timelines, uses, accountability, reporting, sustainability):
Who does the program / cause / organization support? Check all that apply.

ChildrenYouthFamiliesHomelessPoverty stricken children, youth, and familiesVeteransOther _______________________
How many children will be served by the program?
Age range of children served:
How many will be served by the program?
Is this program a one-time event or ongoing?

One timeOngoing
Is the organization / cause local or international?

LocalInternational
Please share any other information that would be helpful in considering this request.
Should be Empty: