Charitable Request

Organization Name:*

We make every effort to support causes which align with our charitable focus areas and meet our other donation selection criteria, such as alignment with our budget and proximity to DeLong facilities. Due to the large number of submissions we receive each month, we are not able to support or respond to every request. If your group is selected for a donation, you will be contacted within a month of submission.

Organization Website, if applicable:

Contact Name:*

First Last

Contact Email:*

Contact Phone:*

Organization Address:*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

501 (C)(3) / Tax ID#, if applicable:

Type of Organization:*

4H or FFA Group or Organization

Food Pantry

Agriculture Education

Fire Dept/Emergency Rescue

Other (please note our focus areas are above)

Event Name, if applicable:

Event Date, if applicable:

Please note that donation requests should be made at least one month prior to donation deadline.

Amount or Item Requested (list value)*

Repeat Donation? Please describe any previous known donations from our company or if this is annual request.*

Donation To Be Used For:*

Silent Auction/Live Auction

Raffle/Door Prize

Equipment Purchase

General Donation Fund

Other, please add detail in description

Nearest DeLong Co. Location (city/state):*

Please note, donations are only considered in areas where we have DeLong facilities. Please look up our location list and determine if we are in your area.

Please describe any affiliation or relationship with a DeLong employee or customer:*

Donation Request Description:*

Please describe below how the contribution will be used and the scope of the event. Please note any significant relationship to agriculture, education or The DeLong Co., Inc.

Attach Any Additional Documents Here:

Max. file size: 10 MB.

Signature of Individual Completing Form:*

Please note that a response will be sent to all requests which are filled out entirely at least one month prior to donation deadline. While we make every effort to support the organizations and causes which align with our philanthropy goals, unfortunately, it is not possible to support every request. Please contact pr@delongcompany.com with any further questions.

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