Donation Request

  • Organization: (Required)

  • First Name: (Required)
    Last Name: (Required)

  • Address: (Required)
    City: (Required)
    County: (Required)
    State: (Required)
    ZIP: (Required)

  • Phone:
    Contact Preference:
    E-mail: (Required)

  • Is your group tax exempt? : (Required)

  • Event Name: (Required)

  • Event Date: (Required)

  • What would you like us to provide? : (Required)

  • What is the purpose of the event? : (Required)

  • How many people are expected to attend the event?: (Required)

  • What will the donation be used for? : (Required)

  • When are the funds needed? : (Required)

  • Upload any materials that would help explain more about your organization or request. Please include a copy of your organization’s W9 form. : (Required)
    (Acceptable Formats: .pdf, .doc, .docx, .xlsx, .png, .jpg, .jpeg, .gif, .tiff)

  • Who would pick up the donation if one is approved?: (Required)

  • Are you willing to post photos of your event on The Ziegenfelder Company's social media sites?: (Required)

  • Is there anything else we should know? : (Required)