Donation Request Form
Thank you for thinking of Purely Wicked for your fundraiser or event! Here at Purely Wicked, we love to give back to our community as much as we can and monthly, we have a set amount of funds designated to do so. All requests should be submitted as early as possible - please submit at least 30 days prior to your event. We are unable to guarantee donation requests for immediate availability. All requests must be in writing - we are unable to fulfill requests made by phone, text or social media messages. Please take a moment to fill out this form. Thank you!
Your Name
First Name
Last Name
Your Email
example@example.com
Your Phone Number
Please enter a valid phone number.
What is your relationship to Purely Wicked?
What organization are you requesting on behalf of?
Their Phone Number
Please enter a valid phone number.
Their Email
example@example.com
What is the organization's mission?
What is your relationship to this organization?
Is this organization a registered non-profit or charity?
Yes.
No.
Has your organization received a donation from us before? If so, please provide details.
What type of donation are you requesting? (I.e. raffle prize, gift card, sponsorship, etc.)
In what way will our donation be used?
How is recognition given to donors?
Event Name
Date of Event
-
Month
-
Day
Year
Date
Time of Event
Hour Minutes
AM
PM
AM/PM Option
Location of Event
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Contact Person
First Name
Last Name
Their Email
example@example.com
Their Phone Number
Please enter a valid phone number.
Any other additional information you would like to include for us.
Thank you!
Submit
Should be Empty: