Donation Request Form | Wilson Kia Serving Flowood, MS

We are committed to serving our community! We enjoy giving & participating in worthwhile projects/events! However, we must prioritize our giving/local advertising requests and evaluate each request carefully. In order to evaluate your request, please fill this out & attach any other information you feel would be helpful. Thank you! Doug Wilson & Darryl Stone

Your Name*

Organization*

Address*

Street Address City State ZIP Code

Phone*

What is your relationship to the organization you are soliciting for?*

If you are working for a fee or percentage, state the amount:

**Are you a 501c3 Tax-Exempt Organization?*

Yes
No

What is the service rendered by your organization?*

Have you or your organization purchased a vehicle from Collierville CDJR?*

Yes
No

If Yes, under what name and when?*

What contribution are you or your organization seeking from us?*

Amount*

If approved, will you agree to the following?*

All donations and employee participation will be recognized on your organization’s website (or blog if you maintain one). The recognition will include a photo provided by the dealership, our logo, and a short summary of the dealership’s support. All articles (or if no article, your website) will include a link back our dealership homepage.
If your organization has a Facebook page, you agree to post a photo that both parties agree is appropriate and thank the dealership's employees for their support of your mission/project. The text portion of the Facebook post will also include a link back to the dealership’s Facebook Page.
If your organization has a Twitter page, you agree to post a photo and thank the dealership's employees for their support of your mission/project. The text will also include a link back to our website or our Twitter account.
If your organization has an Instagram page, you agree to post a photo and thank the dealership's employees for their support of your mission/project. The text will also include a link back to our website.

**You will be asked for your Tax ID should you be approved.

Electronic Signature*

Date of Request*

*

* If your organization has an Instagram page, you agree to post a photo and thank the dealership's employees for their support of your mission/project. The text will also include a link back to our website.

FName

This field is for validation purposes and should be left unchanged.

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