Donation Request Form

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Country *

Organization Type *

State/Province

Please fill out any missing organization information below.

Organization Name *

Tax ID * If you know the Tax ID it will speed up the processing and verification of your request.

Alternate Name *

Is there a different name, DBA or chapter?

Year Established

National Taxonomy of Exempt Entities (NTEE) Code *

Mission Statement *

Org Contact First Name *

Last Name *

Title with the Organization *

Organization Address *

City *

State/Province *

Zip/Postal Code *

Primary Organization Email *

Primary Organization Phone *

Website *

Principal Individuals and Board Members *

The person completing this form who wishes to receive email updates should be entered here

Prefix *

First Name *

Last Name *

Email Address *

Primary Phone *

Cell/Other Phone

Title/Relationship to Organization *

Event/Program Name *

Short Description *

Event Start Date *

Event End Date for Multiday Events (optional)

Event Location and Address of Event * (include Street, City, State and Postal Code)

Number of Guests *

Age Range of Guests *

Item donated will be used for *

Shipping Options

Address to where donation should be mailed (If possible, please provide a commercial mailing address)

Address Type

Address *

City *

State/Province *

Zip/Postal Code *

Country *

Comments

I confirm that I am 14 years or older

* Denotes required fields

This form will expire after 2 hours.

A DonationXchange account will be created and provided in the confirmation email for tracking purposes.

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Donation Request Form

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