Donation Request

Donation Request

Please complete and submit this form so that we may learn more about your organization and the request you're making.
Email
example@example.com
Nonprofit Organization Name:
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
EIN
Point of Contact
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Organization's Website
Instagram Handles
Facebook Handles
Please tell us about your organization’s purpose/mission,
What are the requested items for donation:
What does the organization intended use of the donation?
When would you like to pick up the requested donation? Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
When would you like to pick up the requested donation? Time

Hour Minutes

AM/PM Option
Donation Request Acknowledgment: Please plan ahead for your request. Donation submissions are reviewed weekly on Wednesdays. A follow up email confirming your submission and asking any clarifying questions will be sent by the following Friday. Once donations are approve, a confirmation email will be sent to the email provided. Please check the box confirming you read and understand the "Donation Request Acknowledgment."
Please verify that you are human
Should be Empty: