Donation Request Form
Please fill out this form to request donation from our organization. Please note that we do NOT provide monetary donations, but tangible items of comfort & support, with a focus on Mental Health & Suicide Prevention. We are only able to provide donations to NON PROFIT organizations.
Organization Name
*
Unit (if applicable)
Name of person making request:
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
How many people will benefit from this donation?
Please explain what you are requesting to be donated & what these items will be used for:
*
When do you need these donations by?
*
-
Month
-
Day
Year
Are you able to pick up the donations from our Office at 49th/Louise?
Please Select
Yes! No problem at all!
Would prefer not to....
No- We have no way to pick the items up.
We are run with very limited staff. Please consider picking up your donation if possible.
Is your Organization a Non Profit
Yes
No
I'm not sure
Thank you for your request, and for joining us in supporting the many that struggle with their Mental Health.
We will get back to you within one week to let you know if we are able to fulfill this request.
Submit
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