Hellgate Jetboat Excursions Grants Pass Jetboats, Inc. 966 SW 6 t h S tr e e t ● Gr an ts Pass, Or egon 97526 (541) 479-7204 ● 1-800-648-4874 ● Fax (541) 479 -0051 info @ Hellg a te .co m ● www.h e llg a te.co m Where the Rogue River runs! Our Contribution Committee meets on a regular basis and thoughtfully reviews all requests. We select those, which we believe, are in greatest need of our support. Although many organizations contribute much to their local communities, we unfortunately cannot fulfill each and every request due to our budgetary parameters. We do concentrate our efforts on requests from non-profit organizations within Josephine County; for-profit businesses are generally not considered. CONTRIBUTION REQUEST FORM CONTACT INFORMATION If a donation is granted, please provide contact information below so that we know who to contact and where to send the contribution. Contact Name: ______________________________________________________________________________________________ Mailing Address: ____________________________________________________________________________________________ City: _____________________________________________________________ State: ___________ Zip Code: ______________ Phone: _________________________________ Email: _____________________________________________________________ REQUEST INFORMATION If appearing in person and you have a letter explaining your event, please attach it and complete only those areas not explained in letter. Response Deadline: _____________________________________________ (Please allow at least two weeks for committee review) Requesting: Cash Merchandise Advertising Gift Certificate for: ____Excursions Sponsorship ____River Rock Café Willing to “Buy 1; Get 1” ____Shop River Rock ____Any Non-Profit/Organization Name: _________________________________________________________________________________ Name of Event: ____________________________________________________________ Date of Event: ____________________ Location of Event: ______________________________________________________ Anticipated Attendance: ________________ How would the local community benefit from this event? _____________________________________________________________ How would Hellgate benefit from and/or be recognized for its contribution to this organization/event? ___________________________________________________________________________________________________________ Has this organization received contributions from Hellgate in the past? ___Yes ___No Is this organization a recognized 501(c)3 non-profit? ___ Yes ___ No When? ____________________________ If so, what is the Tax ID #? ________________________ OFFICE USE ONLY Date Request Rec’d: ___________________ Date Request Reviewed: _____________________ Date Contact Notified: _________________ ____Phoned ____Emailed ___Approved ___Denied ____Letter Sent ____Pick-Up ____Mail Out Donation Description: _________________________________________________________________ Value: ______________
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