Donation Request Form - Glace

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In order to help us help you, please return this form AT LEAST 30
DAYS PRIOR TO YOUR EVENT DATE. We cannot guarantee we’ll be
able to review forms received fewer than 30 days prior to your event.
Fax to 816.221.1656 or email to info@glaceicecream.com
Donation Request Form
Today’s Date: ___________________
Name of Event: ____________________________________ ___________________________________________
Name/Description of Organization: _________________ _______________________________________________
Website: __________________________________________ __________________________________________
Event Date: ____________________________________
Donation Needed By: __________________ a.m. / p.m.
Location: _________________________________________ ___________________________
Inside
Outside
Street Address: ___________________________ _____________________________________________
Contact: _____________________________________ Phon e: _________________________________________
Contact Email: ____________________________________ ____________________________________________
Contact Day of Event: ____________________________
Phone Day of Event: _____________________________
Estimated Attendance: ___________________________________________________________________________
If you are seeking an auction item, please specify here :______________________________________________
Please give a brief description of your event and include any materials that will help us make a decision:
___________________________________________________ _________________________________________
___________________________________________________ _________________________________________
___________________________________________________ _________________________________________
___________________________________________________ _________________________________________
___________________________________________________ _________________________________________
___________________________________________________ _________________________________________
For Internal Use Only
Donation Item___________________________________________ _ ______________
Pick-up Date/Time _________________________________ _________________
Total Value of Donation $ _________________________ ___________________
Notes:
Glacé Ice Cream | 4960 Main Street, Kansas City, MO 64112 | 816.561.1117 | www.glaceicecream.com
In order to help us help you, please return this form AT LEAST 30
DAYS PRIOR TO YOUR EVENT DATE. We cannot guarantee we’ll be
able to review forms received fewer than 30 days prior to your event.
Fax to 816.221.1656 or email to info@glaceicecream.com
Donation Request Form
Today’s Date: ___________________
Name of Event: ____________________________________ ___________________________________________
Name/Description of Organization: _________________ _______________________________________________
Website: __________________________________________ __________________________________________
Event Date: ____________________________________
Donation Needed By: __________________ a.m. / p.m.
Location: _________________________________________ ___________________________
Inside
Outside
Street Address: ___________________________ _____________________________________________
Contact: _____________________________________ Phon e: _________________________________________
Contact Email: ____________________________________ ____________________________________________
Contact Day of Event: ____________________________
Phone Day of Event: _____________________________
Estimated Attendance: ___________________________________________________________________________
If you are seeking an auction item, please specify here :______________________________________________
Please give a brief description of your event and include any materials that will help us make a decision:
___________________________________________________ _________________________________________
___________________________________________________ _________________________________________
___________________________________________________ _________________________________________
___________________________________________________ _________________________________________
___________________________________________________ _________________________________________
___________________________________________________ _________________________________________
For Internal Use Only
Donation Item___________________________________________ _ ______________
Pick-up Date/Time _________________________________ _________________
Total Value of Donation $ _________________________ ___________________
Notes:
Glacé Ice Cream | 4960 Main Street, Kansas City, MO 64112 | 816.561.1117 | www.glaceicecream.com

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