Community Donations Request Form

Company

This field is for validation purposes and should be left unchanged.

Organization(Required)

Your Name/Role(Required)

Title(Required)

Mailing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone(Required)

Email(Required)

Contact person's relationship to their organization:(Required)

Describe your organization’s mission(Required)

What services are rendered by your organization?(Required)

What percentage of the donation will be used to help low to moderate income individuals or families?(Required)

How will this donation be used?(Required)

What kind of advertising/signage and/or recognition will CVCH receive, if any?(Required)

What monetary amount are you requesting?(Required)

By what date do you need the contribution?(Required)

Does your organization do business with CVCH?(Required)

Yes

How many participants do you expect at your event?(Required)

A copy of the letter from the IRS stating your organization's 501 (c) (3) status (if applicable)

Max. file size: 50 MB.

W-9 (for tax purposes)

Max. file size: 50 MB.