EmailMe Form - TANNER TEES DONATION RQUEST FORM

What would you like us to donate? How can we help? *

How will our donation benefit the organization/community? *

Please provide information on your good work and the impact you have. If appropriate, please share how you will acknowledge/recognize this donation at your event. It would also be helpful to understand your fundraising goals. Maximum 4000 characters.

Is this request date specific? If so, please share the event date or deadline below.

Attachment (pdf or doc)

Attach information on the event, impact and/or organization that would be helpful.

ABOUT THE ORGANIZATION

Organization Name *

Web Site

EIN/Tax ID

How many individuals/families are served by your organization? *

What is your organization's mission statement? *

HOW DO WE CONTACT YOU?

Name of person submitting the request *

First Last

What is your role within the organization? *

Email *

Phone *

### - ### - ####

Mailing Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region