CommServiceForm - Distinctions Salon

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Community Service Request Form

Request Date *

Funding Date *

Requested Amount: *

Organization Name: *

Organization Tax ID: *

Address, City, State, Zip:

Contact Name: *

First

Last

Contact Phone: *

Email *

Website URL: *

Facebook URL: *

Please Describe Organization's Mission: *

Please describe the Fundraiser Event and how the proceeds will be utiized:

Notification Selection

We would appreciate it if you would take a photo of our donation at your event and send it to us for use on our Social Media platforms. It will help to promote your organization and it's worthy causes. *

Agree
Disagree

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