Donation Request Form

Donation Request Form
Organization Info
Organization Country:
Tax ID:
Organization Name:*
CANNOT CONTAIN # or ' - WILL PREVENT ABILITY TO SUBMIT FORM
Year Established:
Organization Type:*
Please provide organization type:
Will grade school children benefit from this donation?*

YesNo
What grades does your school have?

Pre KKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeHigher Education
How will funds raised be used?*
What grades will benefit from your request?

Pre KKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeHigher Education
Requester's Name:*

First NameLast Name
Title/Relationship to Organization:*
Address: (No PO boxes please)*

Street Address

Street Address Line 2

CityState

Zip Code
Primary Email:*
example@example.com
Primary Phone:*
Please enter a valid phone number.
Mission Statement:*
Website:
Organization's Event Details
Is this a University of Michigan event?*

YesNo
Is this a Michigan Medicine Event?*

YesNo
Event Name: *
CANNOT CONTAIN # or ' - WILL PREVENT ABILITY TO SUBMIT FORM
Description:*
(Please enter an event description that is not specific to this donor or donation request. You may use the comments below for additional details)
Event Date:*

MonthDayYear
Date
Event Location:*
Number of Guests:*
Event Sponsor/Underwriter:*
(If no event sponsor/underwriter, please enter N/A)
Amount Raised:
Request Details
Item Requested:
Items donated Will be used for:*
Attach Files:

Please attach the following documents: Certified 501(c)(3) document (Not Tax-Exempt form), Documents that describe your event, or any other related document.
Cancelof
Please enter the contact name of the person at this organization who requested you to submit your request (if applicable). Leave blank if no one referred you:

First NameLast Name
Comments:
13.15.1 Prohibited Expenses. An institution or a representative of its athletics interests shall not offer, provide or arrange financial assistance, directly or indirectly, to pay (in whole or in part) the costs of the prospect's educational or other expenses for any period prior to his or her enrollment or so the prospect can obtain a postgraduate education.

By checking the box, I acknowledge that we are NOT requesting a donation for anyone or that will benefit anyone in grades 9 through 12 OR grade 7 or higher for Softball or Volleyball OR grade 8 or higher for MBB. Pursuant to NCAA Compliance regulations, U-M Athletics cannot donate items to any entity that serves prospect-aged individuals (grades 9-12, or 7-12 in softball and volleyball or grade 8-12 for men's basketball,), such as high schools, high school scholarship funds, booster clubs, clubs or sports teams for high school students, specific high school students, etc.

By checking the box, I acknowledge that I have read and understand the NCAA bylaws regarding promotional activities. I understand that the organization is under no obligation to fulfill this request. I further understand that the organization reserves the right to request the return of any donated item when these bylaws are not followed.*

Click here for NCAA Bylaws Regarding Promotional Activities
*Please Note:
Your request will be reviewed 4-6 weeks out from your event date. Inquiries on the status of the request before 6 weeks prior to your event may not receive a response. Status of requests will not be received over the telephone.

This request system has been implemented to decrease our carbon footprint and to help protect our environment. We appreciate your support. Thank you.

I confirm that I am 14 years or older
Please verify that you are human*
Admin Use Only
Status:
Item Issued:
Letter Type:
Item Issued Cost:
Inventory
Day After

MonthDayYear
Date
21 Days After

MonthDayYear
Date
45 Days After

MonthDayYear
Date
60 Days After

MonthDayYear
Date
Today

MonthDayYear
Date
90 Days After

MonthDayYear
Date
2 days before

MonthDayYear
Date
Comments regarding your event:
Michigan Athletics Update
Requestor's Response
Compliance Decision
Compliance Decision
Compliance Comments
Should be Empty:

Donation Request Form

Organization Info

Organization's Event Details

Request Details