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North Carolina Courage Donation Request Form
Please provide the following information:
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1.
First Name
(Required.)
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2.
Last Name
(Required.)
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3.
Email Address
(Required.)
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4.
Phone Number
(Required.)
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5.
Title/Relationship to Organization
(Required.)
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6.
Name of Organization
(Required.)
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7.
Is your organization a 501c3?
(Required.)
8.
If yes, enter 501c3 Tax ID#
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9.
What does your organization do for your community?
(Required.)
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10.
What is the name of the event, fundraiser, or initiative that the donation will benefit?
(Required.)
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11.
Event location
(Required.)
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12.
In-hand date
(Required.)
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13.
I understand that submitting a donation request does not guarantee a donation. (Please sign your FULL NAME)
(Required.)
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14.
I understand that requests for specific items will not be guaranteed. (Please sign your FULL NAME)
(Required.)