Pennies for Purpose Application

Name

Organization

Email

Phone

Address

City/Town

State/Province

ZIP/Postal Code

Amount of requested donation:

Amount of requested donation:
	Amount of requested donation: $	Item weight

more items

What is the purpose of your organization?

Please provide a detailed description of the donation request including goals and objectives.

How will the money be spent and who will be the administrative contact?

Please share how this donation will make life better in our communities; and approximately how many people will this affect?

Please upload any document you would like to include to support your request.

One file only.
20 MB limit.
Allowed types: txt, pdf, doc, docx, ppt, pptx, odp, xls, xlsx, ods.

Please upload any image you would like to include to support your request.

One file only.
20 MB limit.
Allowed types: gif, jpg, png, svg.

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