Honey Creek Golf Club Donation Request Form

This form must be completed entirely for your request to receive consideration.

Today's Date: ______

Organization making request: ______

Contact Person (s) : ______

Tax Exempt ID # : ______

Email Address: ______

Group website: ______

Phone Number: ______

Address: ______

City: ______State: ______

Event Information

Date of Event: ______

Name & Location of event and brief description: ______

______

______

______

Number of participants expected to attend event: ______

Will the event be held within 20 miles of Honey Creek Golf Club? ______

How will the donation be used? (silent auction, raffle) ______

How will you be publicizing your event? ______

How will the funds raised through donation be applied? ______

______

How will Honey Creek's Donation be recognized? ______

Phone number to arrange pick up: ______

Organization Information

Please provide a brief history of the requesting organization/group along with its purpose and mission:

______

______

______

______

Has Honey Creek ever donated to your request organization before? ______

If yes, please explain:

______

______

______

Honey Creek Golf Club Donation Request Form

Is your organization a public or private establishment? ______

Indicate the type of service your organization provides:

Health & Human Services Arts & Culture

Educational Environmental

Civic & Community Other: ______

The undersigned hereby certifies that:

a) The information in this application and supporting documents are correct to the best

of his/her knowledge.

b) Donations will be used for projects outlined in the application and agreed to by both

parties.

c) The undersigned also acknowledges that completion and submission of this form

does not guarantee a donation.

X ______

Signature Date

The following information should be attached for consideration:

An official printed flyer, posting or mailing of the event stating the type and date of the event.

Send completed forms via email to:

or mail completed forms to:

Honey Creek Golf Club

1323 Noble Lynx Drive

Boone, IA 50036