Community Donations Application

For a printable version of the application, click here. Printed versions can be sent to [email protected]

Organization Information

Legal Organization Name(Required)

Doing Business As (if applicable)

Federal Tax ID / EIN(Required)

Year Founded

Mailing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Organization Website(Required)

Non Profit Status (501(c)(3), (4), or (6))(Required)

501(c)(3), (4), or (6)

Community(ies) Served(Required)

Primary Contact

Contact Name(Required)

First Last

Title(Required)

Phone(Required)

Email(Required)

Focus Area

Please select the primary focus area of your request:

Focus Area(Required)

Education, including culture and the arts

Health and human services

Social service programs

Request Details

Amount Requested(Required)

Type of Support Requested(Required)

Financial contribution, in-kind donation, and/or team member volunteer support

Project or Program Description(Required)

How will this request produce a measurable community benefit?(Required)

Organization Overview

Annual Operating Budget

Number of Staff / Volunteers

Prior Support from EFCO (if any), including approximate dates and amounts

Certification

I certify that the information provided in this application is accurate and complete to the best of my knowledge, and that I am authorized to submit this request on behalf of the organization named above.

Name(Required)

Name Title

Date(Required)

Community Donations Application

Organization Information

Primary Contact

Focus Area

Request Details

Organization Overview

Certification

FORM MARKS MAILING LIST SIGN UP

Digital

Print

Both (Digital & Print)