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Donor Request Form

- CONFIDENTIAL -


* Required Fields
* Date: * My Phone:
* My E-mail address:
* Fund Name:
 
* Check One:
Philanthropic Fund (B)       Endowment Fund (A)
The undersigned certifies that distribution will not be utilized to: (a) discharge or satisfy a legally enforceable obligation or personal pledge; (b) pay for goods or services received or to be received by donor (e.g. scrip or dinner tickets); or (c) pay dues of donor or members of his or her family to any religious, charitable, or educational organization. Synagogue dues are acceptable.
 
The application will not be "signed" in the sense of a traditional paper document. To verify the contents of the application, the signatory will enter any alpha/numeric character(s) or combination thereof of his or her choosing in the signature block on the application form. The Community Foundation of the Jewish Federation of Orange Countly does not determine or pre-approve what the entry should be, but simply presumes that this specific entry has been adopted to serve the function of the signature. Most signatories simply enter their names, although acceptable "signatures" could include /john doe/; /jd/; or /123-4567/.
          * Signed:
          * Address:
I hereby recommend allocations be made to the following 501(c)(3) charitable organizations:
 
1)
* Amount
* Organization Name:
  Attention of:
* Address:
* City, State, Zip:
Purpose of this Allocation: (500 characters max)
 
2)
Amount
Organization Name:
Attention of:
Address:
City, State, Zip:
Purpose of this Allocation: (500 characters max)
 
3)
Amount
Organization Name:
Attention of:
Address:
City, State, Zip:
Purpose of this Allocation: (500 characters max)
 
 

Please Review All Information For Accuracy Before Submitting.