Donation Request Application

Donation Request Application

Donation Request must be received 30 days prior to date requested.
Organization Name
Tax ID #
Contact Name
Contact Phone Number
Address
City
State
Zip Code
Email
Organization Website
Type a question
Number of People Served
Date Needed By

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Additional Comments
Signature of Requester
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Requests can be emailed to:

pr@adventureparklubbock.com

Or

Contact (806)793-7275 if you have any questions.
For Office Use Only:
Date Received
Amount Issued
Reviewed by
Reviewer Signature
Should be Empty: