DonationXchange - Request Form

Donation Request Form

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Email:
Password:


* denotes required fields
* Organization:
501(c)3 Federal E.I.N.:
* Type:
* Street:	(No PO boxes please)
* City:	State: Zip:

Attach a Document:

(you may attach a document that describes your event, your 501C3 letter, or any other related document)

            
                * First Name:
            
                Last:

* Email Address:
* Telephone:
Fax:

* Event Name:

* Description:

Event Sponsor/Underwriter:

* Event Date:

* Event Location:

* Num of Guests:

Item donated will be used for:

Live AuctionSilent AuctionRaffleOther

Please specify if other:

Referred By Email or Name:
(if applicable)

Comments

Address to where item should be mailed
Mailing address is same as above	Specify mailing address

* Address:	No PO boxes please.
* City:	State: Zip:

*Please Note*
To review the status of your request at any time, please login with your user name and password, which will be emailed to you shortly; status requests will not be received over the telephone. This donation request system has been implemented to decrease our carbon footprint and to help protect our environment. We appreciate your support with all new procedures and policies. Thank you.