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Summary: University of Regina
Faculty of Kinesiology and Health Studies RECREATION SERVICES
DONATION REQUEST FORM
Please complete and submit the information below in its entirety. Submission of this form does not
guarantee that the request will be able to be fulfilled. Requests must be received at least four (4) weeks
prior to your scheduled event. FORMS NOT COMPLETED IN FULL OR SUBMITTED WITHIN THE
REQUIRED TIMELINE WILL NOT BE CONSIDERED. Please write legibly.
ORGANIZATION
Primary Contact Name: _________________________________________________________________
Name of Organization: __________________________________________________________________
Phone: ___________________________________ Fax Number: _______________________________
Address: ________________________________________________ Postal Code: __________________
EMail: _________________________________________________
Web Site: ________________________________________Charitable Organization No.: _____________
Please provide a brief summary of your organization (i.e. purpose/mission) and those who directly
benefit from it?
_____________________________________________________________________________________
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