Donation Request

Name of Organization

Contact Person

Phone Number

Address

City

State

Zip

Reason for donation

Information about fundraiser/event/promotion the donation is needed for

How many people will attend the event/view the promotion?

Date of event/donation

How will Nex-Tech Wireless be recognized at your fundraiser/event/promotion

Type of donation requested
Door Prize
Booth Space
Advertising
Monetary

Donation Amount

Make check payable to

Other

Please specify

Upload supporting documents