Donation Request Donation Request Twitter Today's Date * Requesting organization * Contact Name * Phone Number * Email Address * Mailing Address * City * State * - Select Province/State - Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ==================== Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip * Tax ID# * Is the donation for a non-profit organization? (If yes, please provide your IRS designation as a 501 (C)(3) non-profit organization) * Yes No IRS Designation Is this donation in association with a particular event? * Yes No If yes, when is the event Name of the event and a brief description or attach the event information * Event description file upload What kind of donation or charitable gift are you looking for? * Any additional comments, directions or details we may need to know E-Signature * Date *
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