COMMUNITY SUPPORT REQUEST

We love supporting the communities we serve. However please understand we have a fixed budget for our community donations.

Name

First Name

Last Name

Organization Name

What county does the organization reside in?

Is the organization a registered 401(c)3?

Yes

Date Donation required by

YYYY

What amount of donation are you requesting?

Will you provide a receipt?

Please email it to scott@gathercoffeelounge.com

Yes

Tell us about the organization and how it benefits the community.

Other information?

Please share whatever additional information will be useful.

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