Town Of Atoka Donation Request Form Page 3
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F
ONATION
EQUEST
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Instructions: Please read our Policy and Procedure document before completing this Donation
Request Form. The areas in red MUST be filled out completely for us to process your request.
About the Organization
Name of Organization
Federal Tax ID #
Mailing Address
Phone
City / State / ZIP
Email
Contact Person
Have you previously requested a donation
If yes, when ?
from the Town ?
If yes, was it approved ? Yes
No
Yes
No
Organization's mission statement
About the Program
Is this request for a one-time event of an
If a one-time event, what is the event date ?
ongoing program ?
One time
Ongoing
Description of event or program associated with the requested donation
About the Request
Requested donation amount
Number of people served by event/program
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Parent category: Business