Donation Request Form Home About us Donation Request Form Please use this form to request all donations from Pearl City Media, not a direct request to a staff member. Our team will follow-up with a decision or request for more information. "*" indicates required fields Organization InformationName of Organization/Event* Contact* First Last Contact Email* Contact Phone*Role with Organization*Board MemberEmployeeVolunteerParent/GuardianOtherIs the organization a 501(c)3?*YesNoPlease attach organization's 501(c)3 certificateMax. file size: 1 GB.Does the organization operate in Muscatine County?*YesNoExpanding to includeIs the organization currently a client of Pearl City Media?*YesNoHave we supported this organization before?*YesNoFirst RequestType of Donation Requested* Advertising in Discover Muscatine Publicity through Muscatine Today with Ashley Marketing Services Monetary/Cash Auction/Raffle Item Other If other, please specify donation request type Please detail the donation requested*Why should we donate?*Will Pearl City Media receive recognition for this donation?*YesNoPlease describe recognition opportunitiesEvent Date (if applicable) Month Day Year What is the purpose of the organization/event?*Please upload any marketing materials for the event Drop files here or Select files Max. file size: 1 GB. Non-Discrimination Statement*Organizations seeking support from Pearl City Media must certify that their charitable and/or educational programs and services are offered and provided to the intended beneficiaries without discrimination on the basis of race, color, gender, national origin, religion, disability, medical condition, marital status, sexual orientation, gender identity, veteran or military status, pregnancy, ancestry, age or any other characteristic protected by federal, state, county or local laws, regulations or ordinances. Notwithstanding the preceding, organizations that offer gender-based programs or have programs and services designed to benefit a specific population will not be considered discriminatory for this reason alone. Request complies with non-discrimination statementIf this request is for advertising or marketing services, are other partners/vendors being paid for their services or donating?*100% donationSome paid, some donation100% paid
