Nomination for Sommer Fund Donation

Nomination for Sommer Fund Donation
Thank you for your nomination of an organization or individual(s) who you feel need some humanitarian assistance. You do not need to be a Madonna Ministry Clergy to submit this nomination.

Please allow at least 7 days after submittal to receive a response. If this is a dire emergency, please so note in the comments area below.

Love and light to you

Madonna Interfaith Community
Date*

MonthDayYear
Date
Name of Requestor*

First NameLast Name
Amount Requested*
Amount to be paid over a period of? (example # of Months or one time only) *
Date funds needed *
Preferred form of payment (Check or PayPal)*
Donation on Behalf of: *
Name of the Organization or Individual needing funds
Address of the Beneficiary*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Your Email *
example@example.com
Phone Number*

Area CodePhone Number
Organization Donation Link (Optional)
Reason for Request (limited to 500 words)

0/0
Attach request letter from original requester if available

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