Donation Form Test

Organization Name *

Address *

City, State, Zip *

Website

Social Media Link

Contact Name *

Phone Number *

Email *

Event Date (if applicable)

Amount Requested *

Request Type *

What media benefits are included for Golden West in this sponsorship request? *

What will the donation support? *

Are you a registered non-profit? *

What audience and about how many people will see the sponsorship? *

What can Golden West provide to maximize this sponsorship? *

(i.e. logo, an ad, a banner, giveaway items, etc. Include details like size of ad and whether it's color or black and white, quantity of giveaway items, etc.)

Is there a sponsorship offer with this request? *

(opportunity to advertise or promote Golden West)

What does the sponsorship include? *

(i.e. a logo, an ad, a banner, etc.)

Deadline for Donation *

Please submit requests four to six weeks before funds are needed.

Additional Information

Have a flyer with additional information? Scan or photograph it and attach it here. Do not submit through the mail or at local offices.

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Describe the project *

Please submit requests two to three months before funds are needed.

Total cost of project *

What is your nonprofit designation? *

What other entities, businesses, or individuals are funding or otherwise supporting the project? *

What impact will this project have on your community? *

Golden West may reach out to request additional information. Please allow time indicated within the form (after submission) for a response to the request.

Attach a copy of IRS Letter of Determination. Attach any other additional information here, as well. Do not submit information through the mail or at local offices. *

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