Please complete entire form

Note: completion of the form does not guarantee approval of any donation request.

BuffaLouie’s management will contact organization regarding your request.

* denotes required fields.
 

Name of organization *

Person making request *

First

Last

Email *

Phone

Address

Address Line 1

Address Line 2

City

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Zip Code

Organization's EIN number *

Is the organization a 501(c)3?YesNoI Don't Know

Requesting *

• Gift Certificates
• Food Donation
• Team Sponsorship
• Event Sponsorship
• Other

If Other, please specify:

Date of event for request *

Note: Requests must be made 30 or more days prior to the event/need

Summary explaining the event

Summary explaining how donation would be utilized

How would BuffaLouie's be recognized for donation?

Requesting If explaining

BuffaLouie's logo needed? *YesNo

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