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Donation Request Form

Please complete the Donation Request Form below. In order to allow sufficient time to review each request, all requests should be submitted at least two weeks in advance of the date the donation is needed. All fields required.

Date Request Date Needed
Name of Organization Requesting Donation
Federal Tax ID Number
Does this organization have 501(c)(3) Nonprofit Status?
Number of individuals touched by this organization
Contact Name Contact Title
Phone Email
Address City State Zip Code

Please describe the purpose of your organization and its primary beneficiaries

Select the store you most frequently shop
Has a request already been made at a store?
If so, what store?

Type of Donation Requested? Ad/Sponsorship    Gift Cards    In-store Fundraiser    Merchandise

If gift card donation, amount requested

If merchandise donation, specify exact description and quantities requested

If Event, Name of Event
Date of Event
Purpose of Event
Is there a print deadline?
Do you need a Market Place logo or Ad?
How many people are expected at your event?
What city or county will be served?
Please describe the nature and purpose of your program and event

If Ad, Specific Size (width x height)
Color or B&W
Email address to send digital artwork

Has Market Place donated to your organization's program or event in the past?
If yes, what amount and date?

Our customers like to know how we support our community. How will Market Place be recognized as a sponsor of your organization, program or event?