Nex-Tech Donation Request Form

Today's Date This question requires a valid date format of MM/DD/YYYY.

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Date of Event *This question is required. This question requires a valid date format of MM/DD/YYYY.

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Organization Name *This question is required.

Is your organization a 501c3 non-profit?

First Name *This question is required.

Last Name *This question is required.

Email Address *This question is required. This question requires a valid email address.

Phone Number *This question is required.

Mailing Address *This question is required.

City

State

Zip

Reason for Sponsorship: Information about fundraiser/event/promotion the sponsorship is needed for. *This question is required.

How does your organization utilize its funds? Is the money spent locally? *This question is required.

How many people will attend the event/view the promotion? *This question is required.

How will Nex-Tech be recognized at your fundraiser/ event/ promotion? *This question is required.

Type of sponsorship *This question is required.

Monetary
Door Prize
Booth Space
Advertising
Nex-Tech Express Train*
Nex-Tech Grill**
Other - Please List Please enter an 'other' value for this selection. * This question is required.

*Train reservation dependent on location and availability of staff and transportation. Nex-Tech is not liable for accidents.
**Transportation of the grill is the responsibility of the borrower. Must be picked up and returned to Nex-Tech, Hays. Nex-Tech is not liable for accidents.

Dollar amount of request or value of donation: *This question is required.

Make check payable to:

Please upload any supporting documents for your event.

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