Ticket Donation Request Form

H/Visitor Info/Ticket Donation Requests/Ticket Donation Request Form

Submission does not guarantee a contribution. Donations for approved requests will be sent by postal mail to the address provided. Notifications for requests that are not approved are sent by e-mail if an address is provided.

Name of Nonprofit Organization*
Name of Authorized Representative*
First Last
Mailing Address
Street Address Address Line 2 City State ZIP Code
Phone Number*
E-Mail Address*
Does your organization have IRS 501(c)(3) status?*
- Yes
- No
Federal Tax ID Number for Organization*
Does your organization operate in Lehigh County or Northampton County in Pennsylvania?*
- Yes
- No
Does the purpose of your event or fundraiser relate directly to providing education in the STEM subjects (science, technology, engineering, and mathematics) to students in grades Pre-K-12?*
- Yes
- No
Event Name*
Event Date*
MM slash DD slash YYYY
Event Location*
Event Description*
Description of How Funds Will be Used*
Comments
This field is for validation purposes and should be left unchanged.

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