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MPU Donation Request Form

Name of organization(*)
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Organization Address(*)
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Organization Address
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Organization City(*)
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Organization State(*)
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Organization Zip Code(*)
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Your Name(*)
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Your Email(*)
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Date of event(*)
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Activities/ type of event(*)
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Group/ ages event intends to draw(*)
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Approximate number of youth in City of Manitowoc benefitting from services(*)
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Location of Program or Event(*)
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List any admission fee, registration fee or other fee to attend event or use service(*)
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Purpose/ Agenda of organization(*)
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Is the Organization based in the City of Manitowoc?(*)
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Is this a Political or Religious Organization?(*)
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Please list any MPU Employees or their family members involved with the organization
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Wisconsin 501(c) (3) number(*)
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Date organization or program was formed(*)
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Donation amount requested(*)
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Funds will be used for(*)
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File Upload
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