Donation Request Form

Please complete the Donation Request Form below and attached supporting details. In order to allow sufficient time to review each request, all requests should be submitted at least three weeks in advance of the date the donation is needed. All fields required.

Date of Request:		7/29/2010	Date Needed: Requests must be made at least 2 weeks in advance.
Name of Organization Requesting Donation:
Does Organization have 501(c)(3) Nonprofit Status?			Yes No
Number of Individuals Touched By This Organization :

Name of Contact Person:			Address:
Phone:			City:
Email Address:			State:
			Zip Code:

Select the store you most frequently shop:
Has a request already been made at a store?			Yes No
	If so, what store?
Type of Donation Requested?
	Cash Gift Cards		Ad/Sponsorship Merchandise	In-Store Fundraiser UCrew - Volunteer Program
	If cash or gift card donation, amount requested:
	If merchandise donation, specify exact description and quantities requested:
	If Event, Please Give Name, Date and Purpose of Event:
	If Sports Team, Specify Details:
	If Ad, Specify Size (width x height), Color or B&W, Deadline, Format and E-mail Address to Send Digital Artwork:

Donation Request Form

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