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. Please attach the supporting documents that will help the Contributions Committee review and evaluate your donation request. Helpful documents may 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 other applicable tax documents, sponsorship information if relevant, and any event or deadline details.
*
Upload Files
Drag and drop files here
Choose a file
Cancel
of
Submit
Should be Empty: