Richard Chevrolet Charitable Contributions Request Form
      * fields are required.

    Contact Information

    Contact Information
    First Name: *  
    Last Name: *  
    Email: *  
    Address:  
    City:  
    State:  
    Zip: *  

    Survey Questions

    Survey Questions
    Incorporated as a non profit entity? *  
    yes
    no
    Non-Profit corporation number *  
    Has the IRS granted tax deduction status for your organization? *  
    yes
    no
    What is your Federal Corporation Tax ID number? *  
    Solicitor's name *  
    State your relationship to the organization you are soliciting for: *  
    Is your organization registered with the Better Business Bureau? *  
    yes
    no
    What Services are rendered by your organization? *  
    What contributions are you seeking from us? *  
    Have you or your organization ever purchased a vehicle(s) or parts or service from us? *  
    yes
    no
    If yes, under what name(s)? *  
    Date: *  
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