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* 1. Requesting Individual's Information

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* 2. Organization Information

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* 3. Is this a non-profit organization (501c3)?

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* 4. Which of the following are you requesting (check all that apply)?

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* 5. How will the donation be utilized?

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* 6. Date Donation is Needed by

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* 7. If donation is for an event or program, please include details below (date, time, location, etc.)

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* 8. Include any other documents/materials here.

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