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: ______________