Donation Request Form

Name(Required)

First Last

Tribal ID #(Required)

Name of Organization

Status of Organization (please provide Tax Id #)

Address

Phone

Fax

Contact Name

Title

Title of Event

Event Date(Required)

Date to receive funds by

Please explain the purpose of your request and who it will benefit (Please attach any donation request letters that you may have on your organizations letterhead)(Required)

What is the total amount needed to fulfill your request? (Please attach any budgets that you may have)(Required)

What amount are you seeking from the Cahuilla Band of Indians Aid to Local Government?(Required)

If request is granted, check can be made payable to (please provide address):(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Organization

Memo

W-9 form

Max. file size: 400 MB.

Name of Requestor(Required)

Date submitted(Required)

For Cahuilla Band of Indians use ONLY (below the line):

STAFF:

Hidden

RECEIVED BY

Hidden

Date

COUNCIL

Hidden

Request Approved (Y/N)

Hidden

Amount Approved

Hidden

Comments or Questions

Hidden

Tribal Council (please sign)

Hidden

Date

Hidden

Comments

Name

This field is for validation purposes and should be left unchanged.

Contact Information

Cahuilla Band of Indians
52701 US Hwy 371
Anza, CA 92539

Phone | (951) 763-5549
Fax | (951) 763-2808

Donation Request Form

About

About

Enterprises

Tribal Government

Tribal Administration

Contact Information