Donation Request Application

Organization Information

Organization name (Legal name and acronym, if applicable) *

If your organization is a subsidiary, please list the parent organization

Website URL of event or requesting organization

Is your organization an IRS pre-validated non-profit or public tax-exempt organization, as defined under Section 501(C) [We can only provide support to organizations who can provide us a valid IRS 501C determination letter] *

Yes No

501(C) federal tax ID number *

Format 12-1234567 If you are a non-profit and don’t have a Tax ID number (e.g. Schools, Faith Based Organizations, and Scouts), please just enter 12-1234567 to continue)

Executive Directors Name

Contact Name *

First Name Last Name

Job Title

Contact Phone Number *

Area Code Phone Number

Contact Email Address *

example@example.com

Organization Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Which of the following best represents your organizations primary area of focus? *

Have you ever received a donation from Tootsies in the past? *

Yes No

If yes, list dates, amounts, and nature of donations

Year organization was founded *

Organization's mission and purpose *

Describe the services your organization provides *

Do any Tootsies employees currently volunteer with or serve on the board of your organization? *

Yes No

If yes, please give their name, title, and location

Is your organization currently supported by another women's apparel retailer? *

Yes No

Request Details

Is this donation request for a specific event? *

Yes No

What is the name of the specific program or event? *

Date of event *

Date

Please describe the event or program. If for an event, please include specifics such as location, time, etc. *

How many people are expected to attend the event / program? *

How many people attended the event / program last year? *

Please indicate how you plan to promote this program or event (check all that apply) *

Social Media Website Print Radio TV Other N/A none planned

Do you plan to use the Tootsies logo in your event/program materials if we provide you with a donation? *

Yes No

If so, please explain how you would use the Tootsies logo. (Including formats/file types, etc)

Will Tootsies receive any advertising for this event? *

Yes No

If so, please provide the necessary ad specs and deadline

How will you recognize our contribution? *

Type of Support Requested

What type of support are you requesting? *

Product Gift Card(s) In-store Experience Sponsorship

If requesting gift card support, please include the dollar amount

Please describe the type of support you’re requesting (for example, if requesting product, please include the type, quantity, etc. Please include any sponsorship levels and pricing) *

Most recent 501(c) Determination letter *

Current signed W9

Donation request cover letter

List of sponsorship levels, if applicable

Additional documentation

Upload a File

Select Store Location *

Houston Dallas Atlanta

How did you or the organization hear about our community outreach? *

Website Internet Search Employee Referral Existing Relationship Customer

If you were invited to submit or referred to the Tootsies by an employee or customer, please include their information here:

Please include any final comments