Bellania Donation Request Form
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1Donation Request Form
Thank you for thinking of Bellanina Day Spa in your search for support for your organization. Due to the
large number of requests that we receive, we ask that you please complete and return this form 60 days
prior to your event. Because we do have a limited monthly budget for donations, please understand that
the sooner in advance we receive your request, the more likely we may be able to help you. Thank you!
Please mail to: 201 N. Fourth Ave., Ann Arbor, MI 48104 or FAX to 734.327.0055
Date of Event: ______________________________ Today’s Date: ____________________
Contact Person: ____________________________ Contact Phone: ________________________
Organization: _______________________________ Email (required): __________________________
Is it a 501 (c)?
Yes
No
Address: _____________________________________________________
Has this organization received a donation from Bellanina before?
Yes
No
What is your relationship to the organization? _______________________________________________
What is the event for which the donation will be used? ________________________________________
What is the goal of this event? ___________________________________________________________
How will the donation be used (door prize, auction item, etc.)? __________________________________
How many people will be at the event? ________ Is the event within 15 mi. of Bellanina? Yes
No
Will you need any marketing materials from Bellanina (ex: logo)? Yes
No
What are the demographics of the attendees (gender, age, income, residence, etc.)? ________________
____________________________________________________________________________________
INTERNAL USE ONLY
Date Donation is needed: _________
Date Received: ______________
Approved
Declined
Name & Phone Number of who will pick it up: _____________________
Date: ______________________
Contact phone of pick up person: _______________________________
Item: ______________________
Cost: ______________________
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