Donation Request Form This request form has two sections: Section 1 provides us the basic information about your organization and your mission, as well as information on how Rosie’s team members can recognize their partnership in your event or program. Section 2 provides details on what type of contribution you are seeking.Section 1: Organization InformationOrganization Name(Required)Contact Person Name(Required) First Last Contact Person Title(Required)Phone(Required)Email(Required) Mailing Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Under what IRS section do you qualify as a non-profit? (e.g. 501(c)(3))(Required)Section 2: Contribution DetailsTell us about your area of need.Does this event or program support any other community organizations? If yes, please specifyAt the requested level, how would Rosie’s receive recognition?(Required)(Check all that apply) Banner Space Public Address/Band Announcements Included on Event Posters, Flyers Included on Event T-shirts Logo on Invitations Logo on Paid Ads (Specify Radio, TV, Web or Print) Included in Media Releases Naming Rights (Indicate What Would be Named) Display Booth or Table at Event Other Recognition Select Media For Logo Placement: Radio TV Web Print Naming Rights (Indicate What Would be Named)(Please Specify)(Required)Event or Project Name:(Required)Event Date(s) or Timeline:(Required)How many years has the event/project taken place?(Required)What is the scope of event/project and who does it benefit?(Required)What is the primary purpose for this event?(Required) Community Event: Entertainment – FREE Community Event: Entertainment Community Fundraiser Team Fundraiser Dinner, Lunch, Breakfast Children’s Event Performing Arts Educational Golf Outing Special Project Other (Please Specify)(Required)We need:(Required) Volunteers Food & Beverage Event Planning Assistance Food and Drink Advice A Place for the Event Cash Donation Co-sponsorship Number of Volunteers Needed:(Required)Food & Beverage for how many people?(Required)What kind of food & drink?(Required)Cash Donation Requested(Required)Co-sponsorship Donation Requested(Required)Please tell us how we can help with your event, organization or both?IRS Form W-9 Attachment(Required)Please attach your IRS Form W-9 to fully evaluate your request. Drop files here or Select files Accepted file types: pdf, Max. file size: 50 MB. IRS 501(c)(3) Letter of Determination Attachment(Required)Please attach yourIRS 501(c)(3) Letter of Determination to fully evaluate your request. Drop files here or Select files Accepted file types: pdf, Max. file size: 50 MB. Other AttachmentsPlease attach the organization’s mission statement, a list of sponsorship levels, if applicable, and any additional explanations to questions on this application if necessary. Complete a separate form for each request.Accepted file types: pdf, Max. file size: 50 MB.Completed form should be submitted on or before the dates below: Events within these months: October, November, December due by 5PM on August 15 January, February, March due by 5PM on November 15 April, May, June due by 5PM on February 15 July, August, September due by 5PM on May 15Terms & Conditions(Required)Review the terms and conditions associated with receipt of the requested donation by clicking HERE. I have read and agree to the Terms and Conditions. Signature and Title of Requesting Organization Representative:(Required)PhoneThis field is for validation purposes and should be left unchanged.
