Black River Falls: Donation Request

Donation Request

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Name:*

Email:*

Phone Number

Name of Organization

Nature of Organization

Name of Event or Project

Date(s) of Event or Project

Describe the Event or Project

Fundraising Goal

Donation Request (dollar amount)

List other funding sources and amounts approved

List additional funding sources being solicited and amounts requested

Does your agency/organization have any affiliation with Black River Falls Rotary Club?

List names of Rotarians involved in your project

Recognition/visibility opportunities for Black River Falls Rotary Club will include

Supporting Documentation

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