Email address: Telephone Fax
Temple Name Temple Number
Purpose for Request (select) Please Select Fundraising Event Employer Matching Gift Other If other, please specify This is a request for Please Select Federal Tax ID Number Exemption Letter ID Number and Exemption Letter Permission to Host Foundation Sponsored Event Fundraising Clarification
If this request is for a fundraising event, please provide the following:
Date of Event Month January February March April May June July August September October November December Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 Proceeds to benefit Please Select CEF CRA CEF and CRA
Percentage of Funds to be forwarded to the Foundation (CEF or CRA) %
City where event will be held State
Name of Chairman (if different from above)
Chairman Contact Information Email Telephone
Brief description of the event
A response will be sent to the email address listed above.
