DonationXchange - Request Form

Appearance Request Form

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Organization Info
* Denotes required fields

* Organization:
501(c)(3) Federal E.I.N.:
Year Established:
* Organization Type:

* Name of Benefit Fund:	(i.e. John Doe Benefit)
Partner Bank or Credit Union:	(partnering with benefit)

* First Name:	Last Name: (i.e. CEO, President, Executive Director, or Development Officer at the Organization)
* Street:	(No PO boxes please)
* City:	State: Zip:
* Country:
* Primary Email:
* Primary Phone:
Website:

Requester Contact Information
* First Name:	Last Name:
* Email Address:
* Primary Phone:
Cell/Other Phone:
Title/Relationship to Organization:


Organization's Event Details
* Event Name:
* Description:
* Event Date:
* Event Location:
* Number of Guests:
* Age Range of Guests:
* Event Sponsor/Underwriter:	(if no event sponsor/underwriter, please write N/A)


Appearance Details
* Requesting:	Student Athlete Coach
Dress Code:	Business Formal Business Casual Casual
* What will the representative be doing:
Event Budget:	Do you have a budget for this event? If yes, please specify amount, otherwise enter N/A. (Please include if it is a paid or unpaid appearance. If paid, include the appearance fee)
* Event Times and Length:	(Please include start time and appearance end time. Standard appearance time limited to ONE hour in length)
* Event Address:
* City:	State: Zip:

Attach a Document:

(You may attach documents that describes your event, your 501(c)(3) letter, or any other related document.
Click on Browse button to attach multiple documents. Files will be uploaded when you click submit. A maximum of three attachments will be saved. Attachments must be in one (1) of the following formats: Pdf, doc, docx, xls, xlsx. Limit the file size to less than 4MB.)


Referred By: (if applicable)	(Please enter the contact name of the person at this organization who referred you to submit your request. Leave blank if no one referred you)
Comments:

13.15.1 Prohibited Expenses. An institution or a representative of its athletics interests shall not offer, provide or arrange financial assistance, directly or indirectly, to pay (in whole or in part) the costs of the prospect's educational or other expenses for any period prior to his or her enrollment or so the prospect can obtain a postgraduate education.

By checking the box, I acknowledge that any funds raised in conjunction with this event or appearance will NOT benefit anyone in grades 9 through 12, or grades 7-12 if it involves Men's Basketball.

By checking the box, I acknowledge that I have read and understand the NCAA bylaws regarding promotional activities. I understand that the organization is under no obligation to fulfill this request.

Click here for NCAA Bylaws Regarding Promotional Activities

*Please Note*
Submission of this request does not guarantee that your request will be fulfilled.
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 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.

I confirm that I am 14 years or older