Charitable Donation Request

Every year, Zippo Manufacturing Company and W.R. Case and Sons Cutlery Company contribute to a wide variety of charitable organizations located in our Bradford Pennsylvania region where our employees live and work. If you are representing a charitable organization within the Bradford, Pennsylvania area and wish to submit a request for a donation, please complete the form below and attach your letter of request on your organization's official letterhead.

Please note: Completion of this form does not guarantee request will be fulfilled. Allow 4-6 weeks for processing.

Charitable Organization's Name *

Official Full Name

Organization's Official Address (Must be located in McKean County Pennsylvania)*

Street Address

Street Address Line 2

CityState

Zip Code

Your Name*

First NameLast Name

Your Title*

Executive Director, President, Treasurer, etc.

Employee Number (if applicable)

If you are an employee of Zippo or Case, add your employee number here.

Email*

Phone*

Enter your phone number so we can contact you with any questions please.

Phone Extension

What are you requesting? ( choose one only)*

Financial Donation (monetary only, no sponsorship connected)Event Sponsorship (Includes Ad placement in your program)Product Donation

Financial Donation Amount REquested*

Dollar Amount

Official name of event*

Date of event *

MonthDayYear

Your Request *

Describe your request in detail. How many people would the donation benefit and where are they located, directly, when and where (organization must be within the Bradford, PA area) is the event, etc.

Upload an event promotional flyer for your event here*

Browse Files

Flyer must have event name, where, time, who or what organization it will benefit, reason for event, contact information.

Attach your letter of request on your organization's letterhead here

Browse Files

Upload your request on your organization's letterhead

Request donation by*

MonthDayYear

Attach THE MOST RECENT IRS W9 FORM. YOUR REQUEST WILL NOT BE PROCESSED WITHOUT THis DOCUMENT.*

Browse Files

Upload your non-profit's organization current W9 form here

Please verify that you are human*

By clicking on the Submit button below, you confirm your organization is located in the Bradford, Pennsyvania region and you are the organization's official contact and authorized to submit requests for donations. You also consent that your inquiry, including your personal data, will be transferred to Zippo Manufacturing Company in the U.S.A, which country may not provide the same level of protection of your personal data as your country if outside the U.S.A., for it to handle your request, including by using a third party provider in the U.S.A. For further information regarding the processing of your personal data, please see the privacy policy. If you do not want to use this online form, you may contact us at our mailing address: 33 Barbour Street, Bradford, Pennsylvania, 16701.