Gibson Foundation Donation Request Form – July2017

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Please submit this completed form as a document file rather than a pdf or jpg.

And please enter the requested information solely into this form, rather than refer us to a website or attached document.

If you do not honor this instruction, your donation request cannot be processed or approved.

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Organization Name: ______Date: ______

Organization mailing address: Tax ID/EIN Number: ______

______Please provide us a copy of your IRS designation letter to

______document that your organization is an authorized 501(c)(3).

Contact Person: ______Contact Phone Number: ______

Contact Email Address: ______Website URL: ______

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Organization Mission Statement:

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Which of the Gibson Foundation Mission Directions does your Program support? (Please pick only one)

Education [ ] Music/Arts [ ] Environment [ ] Health/Welfare [ ]

Please explain how your Program supports this Mission Direction: ______

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How many people will directly benefit from this program support? ______

(Please explain how you determined this number): ______

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Has your organization received donations from Gibson Foundation in the past? [Yes] [No}

If so, please provide dates and the donation provided. ______

Specifically, what donation are you requesting, and why? ______

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Does this donation request offer event product exclusivity to Gibson? [Yes] [No}

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Event Name: ______Date of Event: ______

Briefly Describe Event: Date Product is Needed: ______

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Please describe the specifics of how you will be auctioning (or using) any requested Product:

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Shipping Address for Product Donation: (This must be a viable deliver address, and cannot be a P.O.Box.)

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Please email the completed “Donation Request Form” and a brief letter of information on organizational letterhead to: . The subject line of the email should include the words “Donation Request” followed by your organization’s name. (Please provide this completed form in a text document rather than a “pdf” file.)

If you don’t have access to email, you can send the above form via post to:

Donation Request

Gibson Foundation

309 Plus Park Blvd.

Nashville, TN 37217

It is the policy of Gibson Foundation to consider donation requests solely from IRS authorized 501(c)(3)s, or a recognized equivalent charitable authorization from a non-U.S. government. We will not consider requests directly from individuals or organizations seeking to represent a benefitting charity, without that charity’s specific written instruction to Gibson Foundation.

Donation requests are reviewed on a monthly basis after the end of each month. Please understand that we need a minimum of 6 weeks of processing time after the final receipt of a properly completed request form before a donation can be provided.

Please be patient for an answer to your donation request. We will contact you with an update when the donation decision has been completed. Despite our best efforts to communicate accurate information at all times, there are occasionally unforeseen inventory challenges or information errors with the intended donation. We reserve the right to substitute models of any value or configuration at any time we consider necessary.

Be sure to read Gibson Foundation "Donation Request" FAQ before applying for support.

By submitting this donation request to Gibson Foundation, you agree that if your request is approved,

you will provide us with images and a brief update documenting the results of our support in actual use,

within 30 days of the completion of your program.