Charitable Application

Requests require a 30 day or more advance notice

Please submit application to:
Agua Caliente Band of Cahuilla Indians
ATTN: Charitable Donations Department
5401 Dinah Shore Drive
Palm Springs, CA 92264

Is this request for an In-Kind or Monetary Donation?

In-Kind

Monetary

Agua Caliente Band of Cahuilla Indians - In-Kind

Organization Name*

Event Type*

Event Date*

Select one: *

Address:*

City:*

State/Prov:*

Postal Code:*

Phone Number:*

Name:*

Email:*

Tax ID Number:*

(*) Required Fields

Agua Caliente Band of Cahuilla Indians - Charitable Application

Donation Request Instructions

Please answer all questions with complete information.

Project/Program/Event Title:*

Type of Project:*

Event/Sponsorship

Program

General Financial Support

Special Need

Other

Date of Event:*

Location of Event:*

Total Project/Program/Event Cost: $*

Request Amount: $*

Amount Raised to Date: $*

Deadline by which the ACBCI must commit in order to be listed as a sponsor in all printed materials:*

Please state how the funds will be directed, should the ACBCI fulfill your request:*

If the ACBCI fulfills your request, will you be able to provide data of results, and how the money was spent?*

Please attach the following information

One page event/project budget

Source of other funds to support this project

Objectives of project to be funded

Signatory Information

It is fully understood that this donation and / sponsorship is not an admission of any liability, and that is fully responsible for, and shall indemnify and hold Agua Caliente Band of Cahuilla Indians harmless for and against any liability or claim arising from the above described event. I have read and understood the foregoing.

Print Your Name:*

Date:*

(*) Required fields