Charity Partnership Request

Please note: Charitable funds are allocated annually. Each funding request requires approval by the committee.

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Name

First

Last

Phone Number

Organization Name

Organization Address

Address Line 1

Address Line 2

City

State

Zip Code

Type of Charity

Desired Partnership Type

Mission Statement/ Purpose

Is the organization in compliance with all filing requirements of the Internal Revenue Service and the state regulators?

Do you have previous partnership experience with us?

Special Requests/ Comments

Mocama Brewery Taproom