DonationRequestForm(PleasePrintClearly)
Today’sdate:_________________________________
Hostingorganization:________________________________________________________________________
Contactperson:________________________________________________________________________
Phone: ______________________________________Fax:________________________________________
EmailAddress:________________________________________________________________________
MailingAddress:________________________________________________________________________
City:_______________________________________State:______________Zip:_________________
EventDate:______________________________________EventName:____________________________
EventLocation:____________________________________________________________________________
EventDescription(pleasebespecific):
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Itemstobeusedfor:(silentauction,raffleprizes,etc.):_______________________________________________
Pleasereturnthecompletedformwithyourwrittenrequestonyourorganization’sletterheadto:
ByMail: EmailRequests:Janel.Twehous@como.gov
ColumbiaParksandRecreation
Attn:JanelTwehous DropoffattheActivity&RecreationCenter(ARC):1701W.AshSt.
POBox6015
Columbia,MO65025
Duetothenumberofdonationrequestsreceived,asubmittedformdoesnotguaranteeadonation.Wewill
contactyouifweareabletofillyourdonationrequest.
Officeuseonly:
DateReceived:___________________________
DonationRequestFilled:Yes/No
DonatedItem(s):______________________________________________________________________
DonatedValue:____________________________________________________Initials:____________