Rustica’s — Donation Request Form

Thank you for considering Rustica’s as a partner for your event or cause.

We value opportunities to support our community. Please complete the form below, and a team member will review your request.

Organization Information

Organization Name: ____________________________________________

Type of Organization:

☐ Non-Profit (501c3) ☐ School ☐ Community Group ☐ Other: ______________

Tax ID / EIN (if applicable): ___________________________________

Website / Social Media: ________________________________________

Primary Contact Name: _________________________________________

Title / Role: _________________________________________________

Phone: _________________________

Email: _________________________

Event Name: _________________________________________________

Event Date: ______________________

Event Location: ______________________________________________

Brief Description of the Event or Program:

Expected Attendance: __________________________________________

Type of Donation Requested:

☐ Gift Card ☐ Catering Voucher ☐ Food Donation ☐ Other: __________________

Requested Amount / Quantity: __________________________________

How will Rustica’s be recognized?

Has Rustica’s supported your organization in the past?

☐ Yes ☐ No

If yes, please describe: __________________________________________

Please share any other details that may assist in evaluating your request:

I certify that the information provided is accurate and understand that submitting this request does not guarantee a donation.

Signature: ______________________________________

Date: _____________________