Giving Form Test

Charitable Contribution Application Test Form

Charitable Contribution Application

Organizations requesting charitable support of greater than $500 are required to complete this form. If you are uploading files, please make sure each file is less than 5MB. If your files are too large, the form will not submit and you may need to email the files separately. The files may take a minute to upload. If the submission is successful, a confirmation email will be sent to the email address on the form. If you do not hear from us within 10 business days, please call us to follow up.

Organization Name *

Federal Tax ID Number: *

Street Address: *

City *

Telephone *

Contact Person *

Title

E-mail address *

Please describe the mission, nature and purpose of your organization:

Description of Project, Program or Activity

Name: *

Date: *

Dollar Amount Requested: *

Geographic Area Served: *

How many people will this project benefit?

In what county is the project, program or activity?

Please describe the nature, purpose, and benefits of the project, program, or activity for which you are requesting support. If this is an In‐Kind (non‐financial) request, i.e. facility use, employee volunteerism, equipment, etc. please describe needs.

The ALPS Corporate Giving Program requires the following documentation, if applicable.

1. A copy of your organization’s 501 (c)(3) IRS tax exemption letter or a copy of your 501 (c)(3) application to the IRS.

Attach your 501 (c)(3) documentation here:

2. A copy of your organization’s current budget for the project, program or activity.

Attach your budget here:

3. The names of the organization’s Board of Directors.

Please list the names here:

4. Other supplementary materials that describe your organization and its purpose and goals.

Attach any supplementary materials here:

Briefly explain.

You will receive notification within 60 days of submission

Applicant Name

To electronically sign this document and have your application considered, please select 'Accept' to confirm your submission. *

Accept
Decline

Date of Application