Donation Request Form

Our commitment to our community.

As a local company, we recognize the importance of community involvement and try to participate in the many charitable causes our community embraces. VICÍ supports donation requests from organizations compatible with our vision and guidelines. Please take a moment to fill out our online request form to be considered.

In order to plan our giving, we ask that you submit proposals for your event no later than one month prior to event. All requests must be submitted online. Requests submitted by fax, e-mail, or phone calls will not be considered. An email response will be sent within two weeks to notify you if your request will be fulfilled or not.

Please note that our donation budgets are planned on a yearly basis, however, do not guarantee participation to every donation request.

Thank you for your application.

* Required fields.

*Event Date:

*Charity Name:

*Charity Address 1:

Charity Address 2:

*City:

*State:

*Postal Code:

*Contact Name:

*Contact Email Address:

*Contact Phone Number:

- -

Contact Fax Number:

- -

*Please describe the purpose of the donation (event, auction, raffle, door price, etc):

*What programs and/or services does your organization provide?

*Value of charity request:

$

(whole dollars)

*Approximate number of attendees:

*Has VICÍ provided a donation for your organization in the past?

yes no

*What email address should we send our logo to for promotional material?

*Product pickup date & time:

: