Charitable Request Donation

• Today's date
• Name
• Phone
• Email

  *
• Mailing Address

ABOUT YOUR ORGANIZATION

• Organization Name

• Is it a 501(c)3? If so, please submit a copy of the tax-exempt certificate.

  Yes

  No

• Has the organization received a donation from Shipwreck H-D® in the past?

  Yes

  No
• When

• Do you own a Harley?

  Yes

  No
• What Type?
• Your relationship to our organization, if any

• The event at which the donation will be used
• The event's goal
• The exact donation you are requesting

• What will the donation be used for?

  Auction Item

  Price Item

  Raffle Item

  Other
• How many people are expected to attend your event/how many people do you wish to serve?
• Date Needed
• Will Pick Up?

• Submit