ELKS THEATRE AND PERFORMING ARTS CENTER
COMMUNITY OUTREACH/ SCHOLARSHIP
DONATION REQUEST INFORMATION SHEET
The Elks Theatre and Performing Arts Center strives to support and promote the performing arts in the Prescott community. In order to help us expedite your donation request, please fill out the following form in its entirety. If you are requesting on behalf of a business, government, or non-profit organization please accompany this form with a descriptive letter written on official letterhead. If you are requesting on behalf of an individual please include a type-written letter describing the reason for requesting the funds.
Please note that a request does not guarantee funds will be distributed. Requests can only be delivered by U.S. mail. You will receive an email confirming receipt upon delivery to the Elks Theatre and Performing Arts Center.
Thank you for your interest; if you need any further information or help completing this form please email request to firstname.lastname@example.org.
MAIL ALL REQUESTS TO:
ELKS PERFORMING ARTS CENTER
ATTN: DONATION REQUEST
117 E Gurley Street
Prescott AZ, 86301
NAME OF ORGANIZATION/INDIVIDUAL: _______________________________________
SUMMARIZE THE FOCUS OF YOUR ORGANIZATION:
MAILING ADDRESS: ___________________________________________________________
AMOUNT REQUESTED:__________________ DATE FUNDS NEEDED:______________
WILL THIS BE A RECURRING DONATION? :___________
IF SO, WHAT WHAT WILL BE THE INTERVAL?:_______________________
DO YOU CURRENTLY HAVE ANY OTHER DONORS?:__________
ADDITIONAL COMMENTS: ______________________________________________________________________________
By signing this form I confirm that all statements made are truthful and all funds received will go solely to the organization and for the purposes laid out in the form. I understand that filling out this form in no way implies an agreement between the Elks Theatre and Performing Arts Center and the signee for the transfer of any money. I understand that this form will not be valid unless accompanied by a formal written request attached and sent via U.S. Mail. NO WALK-IN FORMS WILL BE ACCEPTED.