Wufoo

Community Giving Form

IMPORTANT NOTE: Community Giving product and financial funds for 2009 fiscal year have been allocated. We are accepting Community Giving requests for product or financial donations for 2010 and beyond.

Organization Name *
Beneficiary of request *
Address 1 *
Address 2
City *
State *
Zip *
Contact *
Email
Phone ### - ### - ####
Organization website
Date contribution is needed MM / DD / YYYY
Please note, request must be submitted at least 60 days prior to when it is needed.
Donation request type
Product Donation Financial Donation
A Boxley Community Gift will help:
Improve Public School Athletic Programs or Facilities Enhance Public Safety Programs or Facilities through a Volunteer Fire/Rescue Department Improve Parks and Recreation Facilities and/or Programs

Your region/community should be an area served by Boxley.
Is your organization a United Way fund recipient/agency?
yes no
Does your organization recognize contributors publicly?
yes no
If yes, in what manner?
Provide a brief description of your request and how a Boxley donation will provide a community benefit. *
Do Not Fill This Out
Do Not Fill This Out