Application

Name of Organiztion*

Charitable donation number 501(c)(3)

Contact Name/Role*

Contact Email*

Mailing Address*

City*

State*
AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingInternational

Zip Code*

Contact Phone Number*

What is the primary focus of your organization?*

Tell us about your event or activity or sponsorship request:*

What kind of support are you seeking?*

Date of the Event

Date of last contribution

How will Dee Zee’s donation be recognized?*

Are Dee Zee employees involved in your organization?*
YesNo

Attach additional details about the event or donation request.