Community Program Donation Request Form

Community Program Donation Request Form
Please complete the below form for your organization to be considered for a donation/sponsorship.

Requirements:
-Organization operates in Rutter’s footprint
-Fosters the betterment of children
-Is a 501C3

If your organization is selected, a representative of Rutter's will contact you.
Organization*
Tax ID (EIN)*
Please attach a W9

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Street address:*
Street address line 2:
City:*
State:*
Zip code:*
Contact Person
First name:*
Last name:*
Phone number:*
Please include area code
Email:*
Have you applied for a Donation/Sponsorship for your organization in the past?*

YesNo
If Yes, when?
Tell us how Rutter's Children's Charities may help your organization....*
Description of need
Requested Amount*
How much are you requesting?
When/Where will the event take place? (if applicable)
(If Applicable)
When do you need to receive the donation?

MonthDayYear
What specific benefits/outcomes will be realized with this donation?
Add event/sponsorship information.

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Would you be willing to provide photos or a short story regarding the outcome of Rutter's Children's Charities donation for use on our social media and to share with our board?

YesNo
Note: The Community Program Donation Request Forms are sent to the Rutter's Children's Charities Board who meet monthly to review submitted donation requests. Rutter's Children's Charities Board meets once a quarter and will review donation requests on a case-by-case basis.
Office Use Only

YesNo
Should be Empty:

Community Program Donation Request Form

Note: The Community Program Donation Request Forms are sent to the Rutter's Children's Charities Board who meet monthly to review submitted donation requests. Rutter's Children's Charities Board meets once a quarter and will review donation requests on a case-by-case basis.