POLYWOOD

Name of Organization *
Organization’s 501(c)(3) (if applicable)
Information on the Organization *

The mission or vision statement, history, who or what the donation serves.
Request *
Amount Requested * $ Dollars . Cents
How the donation will be used *

For donations, enter the type and quantity of furniture requested and how it will be used.
Where this donation will be used *

City/Geography
Date of Event (if applicable) MM / DD / YYYY
Contact Information
Name * First Last
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email *
Phone Number * ### - ### - ####
Are you a current employee of POLYWOOD? *
Yes No
Are you a current dealer of POLYWOOD, or any of its brands? *
Yes No
If yes, which dealership?
Do you have a plan in place to promote your event or sponsorship? *
Yes No
If yes, how do you plan to promote POLYWOOD’s donation or sponsorship?
Do you pledge that your organization’s use of any donation from POLYWOOD will not discriminate against those it serves based on race, color, religion, gender, national origin, disability, marital status, sexual orientation or other basis prohibited by law? *
Yes No
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