Giving Program Request Form

Application for the Baldwin LightStream Giving Program

Although we know that you rely on donations to fund your projects, Baldwin LightStream is limited in the number of projects that we can support each year.

(* = Required)

*Organization Name:

Contact Person:

*Name: *Phone

*Email:

Program Information

Name of program:

*Describe the purpose of the program and who it benefits:

Is this a new or existing program?

What is the total program budget? $.00

*Amount being requested from Baldwin LightStream? $.00

*How will the contribution be used?

List other businessess or community organizations that are involved with this program:

Why should Baldwin LightStream support your program?

Estimated date your project will be completed:

*How will Baldwin LightStream’s gift be communicated to the members of your organization and the public?

If Project is Accepted:

*Who should the check be made out to?

*Where should the check be sent?

Address:

City: State: Zip:

Thank you for completing this application. If your organization is selected to receive a gift this year please understand that it doesn’t guarantee that you will receive a gift next year. You will be informed of whether or not your request has been approved for a donation.