SMMA Council 14719 Donation Request

SAMPLE REQUEST FORM, TO SUBMIT, DOWNLOAD FORM FROM ATTACHMENT BELOW, PRINT, FILL OUT AND MAIL TO

SMMA Grand Knight

4900 Ringer Road

St. Louis, Mo.  63129

Or Deliver to any Knight of our Council.

SMMA COUNCIL 14719 4900 RINGER ROAD ST. LOUIS, MO. 63129

DONATION REQUEST FORM

To request a donation, please fill out the below and submit for receipt no later then the Tuesday prior to the 2nd Wednesday of the Month. Request will be read at our Officers meeting and then at our Business Meeting on the 4th Thursday of the month for approval. If approved, funds will be distributed after our business meeting.

Name of Organization: __________________________________________________________________

Address: ___________________________________ ______________________ _______ ________

Street City State Zipcode

Phone Number: ________________________________

Name of Contact: ______________________________________________________________________

Amount Requested $ ____________ Date needed by: ____/_____/______

Brief Explanation for Request:

Council Approval Date: ____/_____/______ Amount: $ _____________

Authorized Signatures __________________________________________________________________

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