CHARITABLE DONATION REQUEST FORM - iPic Theaters
CHARITABLE DONATION REQUEST FORM
The IPIC Entertainment Donation Program is intended to assist the not-for-profit sector. The program's main goal is to acknowledge not-for-profit volunteers and encourage donations to 501(c)(3) charitable organizations dedicated to the benefit and advancement of the human or animal condition, which benefit the community at large.
The program is not intended for the for-profit sector including organizational meetings, holiday parties, employee incentives, customer rewards or third-party donations (wherein the donation is being passed along through a for-profit company to a charity. No monetary donations are given; our donation is for two Premium Plus tickets ? valid Monday through Thursday, except holidays and holiday eves.
If your donation is approved, you will receive notice from IPIC approximately 3-4 weeks before the date of your fundraising event. Donations are not guaranteed and due to the high volume of requests, not all are approved.
APPLICANT INFORMATION
Organization:__________________________________________________________________________ 501(c)(3) No
Contact:_______________________________________Title:________________________________________________
Address: __________________________________________________________________________________________
City/State/Zip: _____________________________________________________________________________________
Phone: ____________________________________________________________________________________________
E-mail Address:_____________________________________________________________________________________
IMPORTANT 1. COMPLETE APPLICATION. DO NOT LEAVE ANY QUESTIONS UNANSWERED. 2. MAIL YOUR APPLICATION ALONG WITH YOUR 501(C)(3) ELIGIBILITY WAIVER AND A
SELF-ADDRESSED, STAMPED ENVELOPE.
IF ANY INFORMATION IS OMITTED, YOUR APPLICATION CANNOT BE PROCESSED. ONE DONATION PER CALANDER YEAR PER ORGANIZATION
1. When does your event take place? _________________________________________________________ 2. Please describe how the donation will be used:________________________________________________
____________________________________________________________________________________ 3. Please describe who or what will benefit from our donation:
____________________________________________________________________________________ ____________________________________________________________________________________ 4. Is your event, effort or purpose affiliated with any political, religious, family-planning, pro-tobacco-related or pro-
alcohol-related cause or organization? Yes No If yes, please explain: __________________________________________________________________ ____________________________________________________________________________________
To submit: Mail Complete Application and 501(c)(3) form to IPIC Entertainment / Donation Request 433 Plaza Real Boulevard, Suite 335, Boca Raton, FL 33432
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