Request for Donation - Laurel, Washington, Baltimore

Name of Organization*

Address*

Street Address

City

State / Province / Region

ZIP / Postal Code

Name*

First Name

Last Name

Phone*

Email*

Is your organization a non-profit or public tax-exempt organization under Section 501(c)(3) of the Internal Revenue Code?*

Requested Item or Amount*

Description of Event*

When and where will the event take place?*

When do you need to receive the donation? (mm/dd/yy)*

What specific benefits/outcomes will be realized with this donation?*