Sponsorship/Donation Request Form
Evergreen Orthodontics has a passion toward supporting non-profits (501c3) organizations that have a focus on education, nature and/or wellness in Smyrna and the surrounding area.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Company/Organization Name
*
Donation Amount Requested
*
*Please note, we do not accept individual donation requests
Are you a 501c3 Organization?
*
Yes
No
Are you based in the Smyrna/surrounding area? If so, please include the town.
*
Have we donated to your organization before? If so, please list month/year.
*
(Approved donation requests are made one time/year)
Please let us know your organization's mission statement!
Submit
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