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 *
    Email *
    Phone
    Address of organization
    Organization's EIN number *
    Is the organization a 501(c)3?
    Requesting *
    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?
    BuffaLouie's logo needed? *