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Donations
Name of Organization:
Not for Profit Status Number:
Contact name:
Address:
Primairy Phone:
(ex: 555-555-5555)
Secondary Phone:
(ex: 555-555-5555)
Fax:
(ex: 555-555-5555)
Email Address:
Website:
Date donation required for:
Select Date
(YYYY/MM/DD)
Please describe your organization:
Has your organization received a donation in the past? If so, when?:
How would a donation from Lococo's be used? How would it benefit your organization, or your beneficiaries?
Are you or the members of your organization, Lococo's Shoppers?