Donation Requests

Today's Date *

Date Donation Needed *

Contact Name *

Organization Name *

Address (City/State/Zip) *

Contact Phone Number *

Contact E-Mail *

Event Explanation/Purpose of Event *

Donation Amount Requested ($) *Value of each gift card if multiple requested ($)# of gift cards *

Donation/Gift Card to be used for?Purchase of products at Kessler'sPrize(s)Both
Does Club or Organization have non profit status?YesNo