Donation Request Form
Thank you for completing this form to submit your donation or sponsorship request.
1. Requesting Organization's Name:
*
2. Organization's Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
3. Contact Person:
*
First Name
Last Name
4. Contact Email:
*
Please enter a valid email address.
5. Contact Phone Number:
*
Format: (000) 000-0000.
6. Please briefly describe your organization’s goals and how the donation will support your efforts:
*
7. Amount (or Range) Requested for donation (Please include supporting documents and any relevant details for sponsorship requests at the end of this form.)
*
8. Are you a 501(c)(3) Organization?
*
Yes
No
9. Have you been awarded a donation from the Rincon Band of Luiseño Indians in previous years?
*
Yes
No
10. If yes, please list the years of the last three awards:
11. Have you been awarded a donation from Harrah's in previous years?
*
Yes
No
12. If yes, please list the years of the last three awards:
13. Please check the box which best describes the geographical distance from the Rincon Reservation for those served by the donation:
*
On the reservation
Within 15 miles
Within 30 miles
Over 30 miles
14. When is this donation needed by?
*
/
Month
/
Day
Year
Please note: Donation requests may take up to 30 days to process. We recommend submitting your request well in advance of your needed date to allow adequate time for Committee review.
15. Please attach all required and applicable supporting documents for the Contributions Committee to review and evaluate your donation request. Required documents include your organization’s mission statement, a description of how the requested funds will be used, a current W-9 form, IRS Form 990 or applicable tax variants (Form 990, 990-EZ, 990-N, or 990-PF) sponsorship information if relevant, and any event or deadline details.
*
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Incomplete submissions missing the W-9 or 990 may delay review or result in the request not being considered.
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