Organization Information:

All Fields Must Be Completed in order for your donation to be considered

Organization Name:

Tax ID#:

First Name:

Last Name:

Email:

Business Phone:

Cell Phone:

Website:

Address:

City:

State/Province:

Zip:

Mission Statement:

Number of Staff:

I confirm that my organization meets the eligibility criteria outlined on the webpage.

Donation Information:

Item being requested: --None-- Single Flight Flight for Two Full Charter

Please list the location preferred: --None-- Moffett Field Oakland Long Beach Any of the Above

Are you requesting a matching donation under our Matching Gift Program?

Name or event where the donation will be used:

Have we donated to your organization before? --None-- Yes No I don't know

If so, what was the date of the last donation?

Event Information:

Event Date (mm/dd/year):

Ticket Price:

Please describe the event attendees:

Event Details:

Will the item be used in a silent auction or a live auction? --None-- Silent Auction Live Auction

If the item will be used in a live auction can a representative from Airship Ventures assist the auctioner on stage with the promotion? --None-- Yes No

If the item will be used in another format, please include specific details:

Will a complementary invitation to the event be extended to Airship Ventures? --None-- Yes No

If yes please describe:

Will you include Airship Ventures in your event program? --None-- Yes No

If so, what is the deadline for the artwork?

Please list other areas of exposure Airship Ventures will receive for the donation:

Please include any other pertinent information about the event:

All approved flight certificates will be mailed. Please let us know if you prefer a PDF via email: --None-- Mail PDF Will Pick Up