Name of organization:
Organization web site:
Organization phone number: Fax:
Contact person: Phone:
Contact person e-mail:
Are you a Bra-La-La customer?
Is the organization tax exempt under IRS Code Section 501© 3?
Non-profit Taxpayer’s I.D. number:
What is the mission statement of the organization?
The event name:
Date: Time: Est. # of attendees:
Annual event? Year it began?
How do you intend to promote the event? The donation?
What type of donation is requested?
How will the donation from Bra-La-La be recognized?