Non-Profit Donation Application Form

Thank you for your interest in our mission to support non-profit organizations! We greatly value the important work you do in our community, and we are dedicated to making a positive impact through our giving program. To streamline our donation process and ensure fairness, we have implemented an online application for nonprofits seeking contributions for the upcoming calendar year.

Please note that our selection process is competitive, and while we would love to support every deserving organization, our resources may be limited. However, we assure you that each application will be carefully reviewed and considered.

Organization And Contact

Organization Name

Organization Street Address

Organization Address Line 2

Organization City

Organization State

Organization Zip Code

Organization Country

Point Of Contact First Name

Point Of Contact Last Name

Point Of Contact Position / Title

Email Address

Phone Number

About Your Organization

Mission And Purpose

Briefly describe your organization's mission and purpose.

Programs And Initiatives

Provide an overview of the programs and initiatives your organization undertakes to fulfill its mission.

Target Beneficiaries

Who are the primary beneficiaries of your organization's work? Please describe the specific communities, groups, or individuals you aim to support.

Impact And Achievements

Please share any notable achievements, success stories, or significant impact your organization has made in the past.

Non-Profit Status

Is Your Organization Registered As A Non-Profit 501(c)(3)?

Yes

Pending Application

Other Type Of 501 Non-Profit

If Another Type Of 501 Non-Profit, Please Specify

Non-Profit Tax Exempt Number

Your Request

Funding Request

Please specify the amount of funding or in-kind contribution you are requesting for the upcoming calendar year.

How Will The Requested Funds Be Utilized To Support Your Organization's Mission And Programs?

Are You Currently Collaborating With Other Organizations Or Partners?

Yes

If Yes, Please Provide Details

Supporting Documents

pdf, doc, docx, rtf, txt, odt, xls, xlsx, ppt, pptx · max 10MB · up to 5 files

Annual reports, financial statements, impact reports or brochures. PDF, Word, Excel, PowerPoint or text - up to 5 files, 10 MB each. Note that uploaded files are downloadable by anyone who has the link.

Is There Any Additional Information You Would Like To Share That Could Strengthen Your Application?

Confirmation

I Confirm That The Information Provided Is Accurate And Truthful

Type Your Full Name As Your Signature

CONFIRMATION

By submitting this application, I confirm that the information provided is accurate and truthful to the best of my knowledge. I understand that submission of this application does not guarantee funding, and all decisions made by the parent company of Sagentic Web Design (Sagentic, LLC) are final.

* Required field

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