Kocourek Group Outreach… Dedicated to giving back to the community. Kocourek Automotive believes it is important to individually address each contribution request. However, because of the literally hundreds of requests that we receive Kocourek Automotive has established the following required contribution request form.
Download a printable version of this form here.
DONATION REQUEST FORM
Completion of this form is a request only and does not guarantee a donation. In order to be considered, donation requests must be received a minimum of 6-8 weeks prior to the event. Only approved request will be notified.
Organization Name:______________________________________________
Address:_______________________________________________________
County:_____________City:____________________State:______Zip:_____
Telephone: (___) _____-_____ Fax: (____) ______-______
Type of Organization: (please check one)
____Animal Welfare ____Church ____Arts & Culture ____Civic & Community _____Government/Military
____Athletic ____Education _____Business ______Health & Human Services ____Environment/Agriculture
Tax Exempt#/501c3 (attach documentation)__________________
Contact Name:___________________ Contact Telephone (______) _____-______
Event Date:_____________ Event Name:_________________________________
Event Location:______________________________________________________
Description of Event:__________________________________________________
Item to be used for: (Please check one)
Door Price:________ Incentive:________ Silent Auction:_______ Raffle:_____
Live Auction:_______ Other:________________
Donation Shipping Address:_____________________________
Attention:___________________________________________
Address:____________________________________________
City, State, Zip_______________________________________
We give back because we can, because we care and because we believe that everyone doing a little can accomplish a lot. Enhancing the lives of those around us is both a responsibility and a privilege.
Has your organization made a request in the last 12 months?_________
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