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Donation Request Application
*Name of Organization:
*Name of Event:
*Date of Event:
*Place of Event:
*Time of Event:
Number of people this will affect:
*Contact Person Name:
*Today Date
*Contact Person Phone Number
*Contact Person E-Mail:
*Contact Person Address:
*Type of donation:
What type of donation are you asking for (ex. product, services, cash)?
*Amount of Donation Requested:
*Please briefly describe the donation request and how it will benefit the community:
*Please briefly describe how Central Region Cooperative will receive recognition:
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