1600 A lbon R oad
Toledo, O H 4 3528
419.491.1194
Donation R equest F orm
**This f orm i s f or r equests f or t he T OLEDO, O H l ocation O NLY
In o rder t o p rocess y our r equest i n a t imely m anner, p lease h ave t his f orm f illed o ut i n i ts e ntirety a nd t urned i n a t
least 6 weeks in advance of your event. All requests are reviewed monthly and we will contact the approved
applicants. Supporting our community will always be an important part of our company, however, it is
unfortunately i mpossible t o h onor a ll r equests.
Today’s D ate: _ _______________________________________________
Organization: _ _______________________________________________
Organization T ype: _ _______________________________________________
Year E stablished: _ _______________________________________________
501(c)(3) F ederal E .I.N: _ _______________________________________________
Address: _ _______________________________________________
City/State/Zip: _ _______________________________________________
Contact N ame: _ _______________________________________________
Title/Relationship t o O rg: _ _______________________________________________
Contact P hone: _ _______________________________________________
Contact E mail: _ _______________________________________________
Event N ame: _ _______________________________________________
Description: _ _______________________________________________
Event D ate: _ _______________________________________________
Event L ocation: _ _______________________________________________
Number o r G uests: _ _______________________________________________
Event S ponsor/Underwriter: _ ___________________________________________________