COMMUNITY IMPACT REQUEST

Complete Request for Community Support from Weisiger GROUP

Instructions: Please fill out the form based on your request. If you have additional attachments and/or information not covered by this form, please email them to giving@weisigergroup.com. Please only do so once your request has been submitted and make note of your request within your email.
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What is the name of your organization?

What is the mission of your organization?

Are you a non-profit 501(c)(3) organization?

Yes

Please provide your IRS EIN number.

Your Name

Your Phone

Your Email

Organzation's Address

What are your organization's website and social media handles?

If applicable, please note your Weisiger point of contact (name and contact information)

Where will the donation be used? Please provide city and state.

Is there a timeframe associated with your funding request? If so, please elaborate.

Please provide a brief explanation of how your request falls under our giving focus areas (Facility Construction and Support, Expanding Educational Opportunities and Technical Training)

How can Weisiger support you in this initiative? (Ex. Financial Donation, In-Kind Equipment Donation, Volunteers, Sponsorship, etc)

Please expand on your request details below. (Include all request details including project budget, specific details of the request, how you will use Weisiger's resources and anticipated project outcomes)

How will Weisiger's involvement help the organization's mission?

How do you anticipate Weisiger working with you to promote this potential donation?

How will you sustain the project after Weisiger's involvement?

Please add any other request details if necessary.

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