General Information

General Information

All information must be complete and submitted 60 days prior to the event date for consideration.

Date:	Tuesday, March 16, 2010
Organization Name
CEO, President or Executive Director
Contact Salutation	Dr.Mr.Mrs.Ms.
Contact Person First Name
Contact Person Middle Initial
Contact Person Last Name
Contact Title
Street Address
City
State
Zip
Phone	(ex. 4809877898)
Fax	(ex. 4809877898)
Contact Email
Web Site	(ex. www.nonprofit.com)
Are you an Arizona-based organization?	YesNo
What percentage of funds will remain in Arizona?	%
Organization Mission	(300 characters or less)
We require 60 days to process your request. What is the desired Date for a response?

Project Information

Project Information

The option to attach event marketing materials such as invitations, Brochures, Flyers, Save-the-Date Announcements, will be provided upon completion of the form.

Amount Requested in dollars	(ex. 20.00)
Project Name
Project Type	Fundraiser Special Event Program Other
Request Type	Sponsorship Funding
Brief Description of Your Request	(300 characters or less)
	Golf event
	Breakfast Lunch Dinner
	Ticket
Date RSVP Needed

Benefits Requested

Benefits included in this request

(Please check all that apply and attach a complete list of benefits)

The option to attach event marketing materials such as Invitations, Flyers, Brochures, Save-the-Date Annoucnements will be provided upon completion of the form.

	Address attendees at event
	Advertisement
	Our logo/name in event program
	Our logo placed on your website
	Our logo/name in media and/or publicity
	Our logo on invitation or other mail material
	Other benefits
	Your application will be saved for 30 days only. Instructions on how to return to your form will be on your confirmation page.

Type of Organization

Organization Information

Type of Organization	Choose Non-Profit Government Organization Educational Organization Chamber of Commerce Foundation Faith Based Organization Other
	Attach only the applicable materials based on your Type of Organization. (Refer to attachment section)

 

Better Business Bureau Member?	YesNo
United Way Recipient?	YesNo
What other funding sources and amounts do you anticipate for this project?	(100 characters or less)
Please note which sources are secured

Prohibited Materials

Prohibited Materials

Please note, prohibited materials such as private health or claim information should not be attached to this form.

 

Attachments

Attached documents will not be saved. They must be attached at the time the finalized request is submitted.

If your Type of Organization is a Non-Profit, Chamber, Foundation or Other it is required to attach the following materials:

• Current Officers List
• Current Board of Directors List
• Tax Determination Letter such as 501 (C)(3), 501 (C) (6) or W-9

If the required materials were previously submitted this year, you do not need to submit them again.

 

 

	I certify that the above information is correct and that I am authorized by the governing board of this organization to submit this application.
Submitted by
Title
Phone Number	(ex. 4809877898)
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