Jose'S Southwest Grille Donation Request Form
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1DONATION REQUEST FORM
5240 W. Sunset • Springdale, AR 72762
(479) 750-9055 • Fax (479) 750-9166
At Jose’s Southwest Grille we strive to be strong members of our local community. Part of that initiative is
giving back to the community in which we do business. Any function or group that is holding an event that
benefits the community or a non-profit organization is eligible to receive a charitable donation.
To request a donation, please send or fax in the following items to
Jose’s Southwest Grille at the above address ATTN: Donation Request
Please include this completed form AND a formal written request on your organization’s
letterhead. Donation requests must be submitted at least 3 weeks prior to your event.
Organization ___________________________________________________________
Type of Organization
Business
Non-Profit Group
Church
Civic
School
Other________________
Address________________________________________________________________
City ____________________________State ________________ Zip_______________
Contact Name________________________ Phone # ____________________________
E-Mail ______________________________ Fax No.____________________________
Event Details
Name/Type of Event _______________________ Event Date _____________________
Description of Donation Needs______________________________________________
_______________________________________________________________________
How often do you eat at Jose’s Southwest Grille? ________________________________
What is your favorite item on our menu? _______________________________________
*Completion of this form is a request only and does not guarantee a donation.
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