DONATION REQUEST FORM

DONATION REQUEST FORM
Name of your organization:
Your Name:

First NameLast Name
Your position:
Contact person (if other than you):
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone:
Please enter a valid phone number.Format: (000) 000-0000.
Email Address:
example@example.com
Are you a non-profit charitable organization?
Tax ID# (required)
If this doesn't apply to your event enter NA in the box above.
501(c)(3) (required)
If this doesn't apply to your event enter NA in the box above.
Name of Event:
Date of Event

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Nature of event (scholarships, raise awareness, raise funds)
Is there a ticket/admission fee to this event? If yes, please move to answer the next question)
If you answered yes to the above question, how much are the tickets?
What will the donation be used for?
What organization will receive the proceeds of your event?
Will Virginia International Raceway be included in any advertising you do for your event? If yes, please list below
Describe types of advertising you plan to include Virginia International Raceway in:
Will you distribute VIR brochures at your event? If yes, please choose the quantity below:
Quantity of brochures you would like to have for your event:
If you need a different quantity than the one listed above, please indicate it in the space below.
Donation Agreement:

I agree that the above information is accurate. I understand that this is a request and I will not receive a donation from Virginia International Raceway until the Donations Committee has approved it. I am preparder to answer any quesitons related to the submission and provide necessary paperwork if asked. I will use the donated item/tiemms for the purpose to which it is intended and will not re-sell the items for profit. Failure to comply will negatively impact VIR's consideration of future requests.
Attach a written request on your organization's letterhead 60 days prior to your event.

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Signature
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