Donation Request Form
Requests must be submitted a minimum of 60 days from date needed. If your application is approved, your organization will receive vouchers for two movie tickets and two medium combos that can be redeemed at the Michigan and State Theaters.
Organization
*
Contact Name
*
First Name
Last Name
Contact Email
*
example@example.com
Is your organization a 501(c)3?
*
Yes
No
Is your organization located in Washtenaw County?
*
Yes
No
What type of event or fundraiser will your request be supporting?
*
0/200
Date of your event or fundraiser.
*
-
Month
-
Day
Year
Date
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Submit
Should be Empty: