Charitable Donation Request Form

The goal of The Drake Durkee Foundation is “To inspire, educate and motivate children to realize the impact of intentional acts of kindness and to empower kids to proactively create an environment of inclusiveness for all children” As a part of realizing this goal, The Drake Durkee Foundation is accepting applications for donations for individuals and organizations who have the same goals in mind.

Please fill out the below form. A board member will review your application and reach out to you.

 

APPLICANT CONTCT INFORMATION
Applicant Name *
Applicant Name
Applicant Address *
Applicant Address
Applicant Phone Number *
Applicant Phone Number
Organization information
If you are an individual requesting a donation, skip the next four questions
Organization Address
Organization Address
(If Different from above)
Organization Phone Number
Organization Phone Number
(If Different from above)
http://
Between 1-4 sentences about the organization
FUNDING INFORMATION
How will the funds be used? *
Check all that apply
$