Community Giving
Donation Request Form for Organizations
Requesting Organization
*
Is the requesting organization a 501(c)3 as classified by the IRS?
*
Yes
No
Upload tax exemption status documentation
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Organization Person to Contact
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Are you a current Collier Drug Stores customer?
*
Yes
No
Type of Donation Requested
*
Requested Amount
Mailing Address for Donation
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is this donation request in association with a particular event?
*
Yes
No
If so, what is the Name of the Event?
Date of the Event
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Month
-
Day
Year
Date
Description of Event
How will Collier Drug Stores be promoted?
Can we supply our logo for your event/material?
*
Yes
No
Are other drug stores participating?
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Yes
No
Has your organization previously REQUESTED a donation from Collier Drug Stores?
*
Has your organization previously RECEIVED a donation from Collier Drug Stores?
*
Why did you select Collier Drig Stores to solicit a donation?
*
Submit
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