Donation Request Form | Palace Playland

Fields with an asterisk are required.

Instagram
This field is for validation purposes and should be left unchanged.
Name*
First Last
Organization Name*
Organization Type (select one)*
- 501-C (3)
Address 1*
Street Address Address Line 2 City State ZIP Code
Address 2
Street Address Address Line 2 City State ZIP Code
Email Address*
Organization Tax ID*
Organization Website
Provide a brief description or summary of your organization and your organization’s mission, not the donation request.*
Who will your request benefit? (select one)*
- Children
- Education
- Needy Families
Briefly describe your donation request.This will allow for a more thorough consideration of your request and will help avoid any delays in the approval process.*
Deadline date if your request is associated with an event:
MM slash DD slash YYYY
Check the box and click 'submit'