Express Services, Inc. Philanthropic Committee

Express Services, Inc. – Philanthropic Committee Request for Charitable Contribution PLEASE COMPLETE AND ATTACH TO YOUR PROPOSAL

Date: 2018 年 4 月 8 日 Organization: Contact Person: Phone: e-mail Address: Federal tax ID #: Are you a 501(c)(3) organization?

Category (check one) Arts Beautification Children Community Education/Historical Medicine/Research Other (please specify):

Event Details Event: Date: Deadline:

Request for Donation In Kind Donation Sponsorship Other Amount: $

Benefits to Express (publicity, recognition, tickets, etc.)

Any Relationship / connection to Express? Previous support? …How much? $ …When?

Action of Philanthropic Committee Date of Review

 Funded / Amount $  Not funded at this time / Rank (circle one) 1 2 3 1 = meets criteria; consider later if funds are available 2 = meets criteria, but not of utmost importance 3 = does not meet criteria  Forward for further review to:

ATTACH THIS COVER SHEET AT THE FRONT OF YOUR PROPOSAL AND DELIVER TO: Express Services, Inc.  Philanthropic Committee  9701 Boardwalk Boulevard  Oklahoma City OK 73162

PLEASE NOTE: INCOMPLETE PROPOSALS CANNOT RECEIVE CONSIDERATION