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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 *


    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? *YesNo