Ny University Donation Request Form
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1
2Asset Management
Administrative Services
105 East 17
th
Street, 2nd Floor
New York, NY 10003-2105
Tel: (212) 998-1040
Fax: (866) 462-1422
Email:
asset.management@nyu.edu
Web Address:
Donation Request Form for Not-For-Profit Organizations
1. Organization Name:
__________________________________________________________________
___________________________________________________________
2. Address
________________________
_______________________
3. Contact Person
Job Title
______________________________________________________
4. Email Address
_______________________
_____________________
5. Phone Number
Fax Number
________________________________________________________
6. Tax Exempt#
(Please provide a copy of your government exemption certificate with this form)
7. What programs and/or services does your organization provide?
______________________________________________
_____________
8. Approximately how many people take advantage of services offered?
9. Have you requested donations from NYU in the past?
Yes
No
10. Please list items your organization is currently requesting:
______________________________________________
11. Generally, NYU cannot provide delivery of donated goods. Can your organization arrange for pick-up?
Yes
No
Instructions
A "Waiver of Liability" form must be signed at the time items are removed.
•
A copy of your Government Exempt Certificate must be filed with our office prior to removing
•
items.
If you are submitting on-line, the "Waiver of Liability" form must be signed when picking up
•
items.
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Parent category: Business