CHARITABLE DONATION REQUEST Please complete this form to submit your request for consideration to the Society Insurance charity committee. Full Name *Phone Number *Email Address *ABOUT THE ORGANIZATIONOrganization Name *Organization Address *Organization City, State and Zip *Is the organization a 501(c)(3)? *YesNoABOUT THE REQUESTPlease explain what you are seeking*If applicable, the date of the event:If applicable, the dollar amount or range sought for support:SelectHas Society Insurance supported your organization in the past?YesNoNot SureSelectHow would you categorize the support you are seeking?Supporting HungerDisaster ReliefScholarship ProgramEnhancing Quality of Life in the CommunityOtherUpload supporting documentation (Please include documentation to confirm 501(c)(3) status and any other information regarding your request):Drag and Drop (or) Choose FilesAny other information that would be helpful for us to know?Please note that Society's charity committee typically meets once per month to review all new submissions. After your submission has been reviewed, a member of the charity committee will be in touch. Thank you! Send Message LET’s GET STARTED COUNT ON YOUR LOCAL INDEPENDENT AGENT TO PROVIDE THE BEST COMBINATION OF SERVICE AND PROTECTION FOR YOUR BUSINESS. FIND AN AGENT
