Date: | Oct 1, 2023 |
Organization Name: | |
Address: | |
City: | |
State: | |
ZIP: | 12345 or 12345-6789 | Website: | ++ You must be a registered 501(c)3 Organization ++ |
Tax ID #: | 12-3456789 |
Contact first name: | |
Contact last name: | |
Contact phone #: | 123-123-1234 |
Contact Email: | |
Number of toys you are requesting for this season: | (Must be a number) |