Responsive Charity Donation Form

Charitable Request Form

Our Charitable Requests Committee meets on the 1st Tuesday of the month from August-May. Any requests made after the first Tuesday of April will not be considered until the following August. If your request is in excess of $250, please submit your request 45 days prior to your event to allow our membership to vote on the matter. If you are requesting $250 or less, please submit your request 10 days prior to the months' Committee meeting. If you are submitting a request for an event, please submit request 30 days prior to your event. All requests submitted after the deadline will not be considered until the following month.
Organization Name
Organization Purpose
POC Full Name *

First Name Last Name
POC Title in Organization
POC E-mail *
POC Phone Number *

Area Code Phone Number
Amount Requested
Total Cost of Project or Event
Date Funds Needed
Number of Individuals who will benefit
Please describe in detail how you will use the funds to benefit the community.
Please describe the types of fundraising you have done, or will be doing, to support your activity.
What other organizations have you requested funds from?
If approved, who should the check be made out to? *Checks cannot be made out to an individual. *
Address to mail check to

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Please upload any additional paperwork that you have (i.e. cover letter, event flyer, solicitation letter, etc).

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Charitable Request Form