Donation Request Form
Here at Tomahawk Pharmacy, we love to give back to our community! Please fill out the following form to request a donation for your cause or event!
Contact Name
*
First Name
Last Name
How would you like to be contacted regarding this request?
*
Email
Phone call
Email address:
Phone Number:
Please enter a valid phone number.
Format: (000) 000-0000.
Organization Name
Name of Event or Cause
Date of Event or Cause
*
-
Month
-
Day
Year
NOTE: event date must be at least 30 days in the future to allow adequate time for processing
Type(s) of donation requested:
Monetary
Gift Basket
Other
Any additional notes?
Feel free to include any links to social media events or documents!
Terms & Conditions
*
I confirm that I am a representative of the above mentioned charity or organization and that this request is being made at least 30 days prior to the event date. Requests submitted less than 30 days prior have a high likelihood of being denied. All donations are expected to be picked up from Tomahawk Pharmacy within a reasonable period of time after being alerted it is ready. If your organization has special circumstances that prevent the donation from being picked up, please email community@tomahawkpharmacy.com.
Optional: Upload any flyers or additional information
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please verify that you are human
*
Submit
Should be Empty: