Charitable Donation Request Form

General Information This form should be completed and submitted electronically. Requests should be submitted 2-4 weeks in advance to allow time for review. Due to the large number of requests, the Ben Hogan Golf Equipment Company is unable to guarantee a response to all donation requests. Today’s Date ____________

Organization Information _______________________________ _______________ ________________________ Name of Organization EIN/Tax ID # 501(c)(3) status since

_______________________________ _______________ _________ ____________ Mailing Address City State Zip Code

_________________________ _________________________ __________________ Telephone Number Organization Website Contact E-Mail Address

_______________________________ _________________________ ____________ Name of Contact Title or Relationship to Organization Contact Number Has the organization received support from Ben Hogan? ____ When? ______ Items Received? _________

Program Information ______________________________________________________ __________________ Event Information Items Requested

______________________________________________________________________________ Purpose of Support

______________________________________________________________________________ How will the funds raised for the program/event be used?

____________________________ __________________________ __________________ Community the program will serve Expected number of people to attend Date of program/event

______________________________________________ ________________________ Signature of Applicant Date