Backcountry Boutique

Backcountry Boutique

Donation Request Form
Thank you for thinking of Backcountry Boutique for your fundraiser or event! We love to help our community when it is within our budget and ability to do so.

All requests must be submitted in writing, through this form. We will not consider requests made by phone, text, or social media messages.

Requests should be submitted as early as possible- Please submit 30 days prior to your event. We are unable to accomodate requests for immediate donations.
Today's Date
Contact Person

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Have you shopped with us before?
Organization Name
Organization Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is this organization a 501c3?
If yes, please provide a 501c3 number.
Organization Mission
Has your organization received a donation from us in the past?
If yes, when?
Your relationship to the organization
Name of Event
Event Date
Type of Event
How will the donation be used?
How is recognition given to donors?

Other
Please explain:
What type of donation are you requesting?
Please upload any documents you would like us to consider or fill out.

Cancelof
Additional comments:
Date Donation is requested by.

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Person who would be picking up donation

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Thank you for submitting your request!

Submission of this request is not a guarantee of donation availablilty. If we are able to accomodate your request, we will contact you.

Please understand that we receive an overwhelming amount of requests and it is not feasible to fulfill all of them.
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