Request for Discount / Donation Form

Thank you for your interest!
START
 
Date: *

 
General Information

 
Name of Organization: *

 
Address: *

 
City: *

 
County:

 
State: *

 
Zip Code: *

 
Organization Website:

 
Fax:

 
Contact Person: *

 
Contact Phone:

 
Are you a Gramophone customer?

     
 
is the organization tax exempt under IRS Code Section 501-3? *

     
 
Non-profit Tapayer's ID Number:

 
What is the mission statement of the organization?

 
Your annual budget?

 
The Event

 
Name of the Event:

 
Date:

 
Time:

 
Estimated number of attendees:

 
Location:

 
Is this an annual event?

     
 
Year it began?

 
How do you intend to promote the event?

 
The Donation

 
What type of donation is requested?

 
How will the donation from Gramophone be recognized?

Thank you so much!

A Gramophone Representative will respond to your inquiry soon.
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