Name of organization:

Address:

City, State, ZIP:

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Contact phone number:

Email address:

Date donation requested by:

Describe the project/activity:

If applicable, please provide your Federal Tax ID #:

Donation requested:

Monetary: Other:

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Donation is not confirmed nor guaranteed by completing this request. Please include any additional information such as cover letter or sponsorship forms. Requests can take 2-3 weeks for review. If you have any questions, please email marketing@farmersco-operative.com or call 402-946-2211. Thank you!

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Donation Request Form