Request a Donation

2. Donation Request Form

   The completed donation request form must be submitted 15 business days (three weeks) in advance to allow for approval and processing.

4. Name of Organization:*
6. Contact information for the request:
8. First Name*
9. Last Name*
11. Phone Number *
12. Email Address*
14. The mission and goal of your organization:*
16. Purpose of the requested donation:*
18. Tell us about your target audience:*

    (Family, business, 21 +, etc.) 

20. Event date:*
21. Donation due date:*
22. Suggested value for request:*
    -- Select One --$50$75$150$200$250$300
24. Has your organization received a donation previously from the Dodge City Convention & Visitors Bureau?*

    1. Yes
    2. No
25. If so, what was the last date a donation was requested?
29. Will donation be picked up?

    1. NO
    2. YES
30. Will donation need shipped?*

    You will be responsible for postage.

    1. NO
    2. YES
32. First Name
33. Last Name
35. Shipment Address
37. City
38. State
39. Zip
Leave This Blank:


41. 1. Receive an email copy of this form.
42. Email address

    This field is not part of the form submission.

43. Submit Submit and Print

* indicates a required field