Community Donation Request Form

We are committed to supporting locally based, not for profit organizations that directly benefit members of the Ann Arbor community. If you are not from a not-for-profit organization, we consider you a customer and thank you for your patronage.

We ask that everyone requesting a donation understand that we need time to evaluate and respond to requests. Please submit this form no later than 30 days before you need an answer. Thank you!

Please Tell Us About Your Organization


Name of Organization *

Tax ID Number (required for all donations) *

Address (please include city, state, zip) *

Contact Name *

Email Address *

Telephone Number *

Are you based in Ann Arbor? *	Yes No

Are you a not for profit? *	Yes No

What is the stated purpose or mission of the organization? *

Who specifically benefits from the activities of the organization? *

Please list key administrators and board members

Please Tell Us About Your Donation Request

Is this request to support a specific event? *	Yes No

If the above answer is 'Yes,' please describe the event, including the date, who will attend, and what the desired outcome is for the organization and its beneficiaries.

What sort of donation are you requesting? *	Direct financial contribution Purchases of Goods or Services (eg ad space) Product Donation Discount on Product

Please describe in detail what the requested item is: *

Please describe in detail how our donation would help your organization to acheive its desired outcome

Please enter the characters you see in the box below (case sensitive.)