Charitable Contribution Request Name of Organization Organization Website Organization Description Organization Address Street Address City State Zip Code Tax Information Federal Tax # (EIN) 501(c)3 organization? If yes, provide proof of status. (File May Not Exceed 3MB) Current Operating Budget Please attach a copy of your current line-by-line operating budget. (Required field) (File May Not Exceed 3MB) List of Officers/Board Members Please attach a list of all current officers and board members. (File May Not Exceed 3MB) Contact Information Contact Name Title Phone Number Email Address Event / Donation Details Event Name Type NA if there is no event. Date of Event Type NA if there is no event. Item or Amount of Funds Requested Specific Purpose of Request Requested Funds Due By (MM/DD/YYYY) Deadline for Logo/Materials Submittal Additional Attachments Please attach any brochures, event invitations, or other relevant documents specific to this request in one file. (File May Not Exceed 3MB)