Wabash|Charitable Giving Form - Community Outreach

About Us

Charitable Giving Request Form

Organization

Check Payable To:

Organization Street Address

City

Zip/Postal Code

Primary Contact Name

State/Providence

Country

Title

Phone Number

Fax Number

Primary Contact Address (If different than Organization Address)

City

Zip/Postal Code

State/Providence

Country

About Your Cause

Briefly describe the activity or project for which you are requesting a contribution

Amount you are requesting from Wabash

What is your target fundraising goal?

Will you be receiving funding from other sources? If yes, please list below.

Date donation is needed by

How many people will be impacted by this funding?

What is the specific timeline for this project?

If there is an event associated with this fundraiser, what percentage of the event's revenue goes to your organization?

What is the date of the event?

Where will the event be held?

Who or what special interest group will benefit from this project?

What area will this funding impact?

If Wabash supports this project, how will you measure its effectiveness and follow up with us regarding your results?

About your Organization

Does your organization have a budget?

Yes
No

For each $100 donated, how much is applied to:

Program:

Fundraising:

Future Resources:

Administrative:

Provide a brief background of your organization (board or parent organization, mission statement, etc.).

Briefly describe your organization's financial accountability.

List opportunities for Wabash to be recognized for contributing to this organization.

List any potential non-monetary support opportunities associated with this request?

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Contact us

General Inquiries: (765) 771-5300
Investor Relations: (765) 771-5310
Customer Support

How can we help?

Enter Query

Name

Company

Phone Number

City

State/Province

Zip/Postal Code

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