* Required questions must be answered
*
Date
(mm/dd/yyyy):
*
Name of Organization:
*
Tax ID #:
*
First Name:
*
Last Name:
*
Address line 1:
Address line 2:
*
City:
*
State:
-- Select One --
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
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MD
ME
MI
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MO
MS
MT
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NF
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NT
NU
ON
PE
QC
SK
YT
*
Zip Code:
Telephone:
(including area code)
Email:
Organization's Mission and Goals:
Date of Event:
(mm/dd/yyyy)
Title of Event or Nature of Request:
Type of Donation Requested:
Briefly explain what the donation will be used for:
How will The Mill Casino • Hotel be recognized for its donation?
Date donated item
is needed by:
(mm/dd/yyyy)
Please submit this application to The Mill Casino • Hotel no later than two months prior to your event. Donation request materials will not be returned.
* Required questions must be answered