Donation Request Form

Please allow 2 weeks for a response. We will notify the contact person of our decision. Thank you!

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* 1. Name of Organization

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* 2. Mailing Address of Organization

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Email Address

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* 3. Federal Tax ID Number

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* 4. Contact Person

Name

Email Address

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* 5. Please describe the event and/or cause for donation

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* 6. Date of Event

Please enter date

Date

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* 7. Average Donation Amount

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* 8. If anyone in your organization is a customer of Springer’s, please note here:

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* 9. Has Springer's donated to your cause in the past?

Yes

No

Other (please specify)

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* 10. If approved, what store location would you like to pick up your donation?

Bath, ME

Portland, ME

Portsmouth, NH