Gift Card Donation Request An asterisk (*) denotes required fields. Please note that a submission of a gift card donation request does not guarantee receipt of a donation. Date of Donation Request MM/DD/YYYY Information About Your Organization Name of Organization Does Organization have 501(c)(3) status? Yes No Tax Exempt ID# Website Contact Person Email Address Must be a valid e-mail address, e.g. email@domain.com. Phone Number (XXX) XXX-XXXX Street Address Address Line 2 City State / Province / Region Zip Code Country Description of Organization's Focus & Mission Proposal Description & Details How does the proposal fit with The Hub's Mission? Promotes cycling or other forms of active transport Promotes environmentally friendly initiatives Program or event is within The Hub's business communities (Local) Select all that apply. What is the project or event for which the gift card will be used? Total Requested Gift Card Amount Date the Gift Card Donation is Needed MM/DD/YYYY Keep this field blank
