Please use this form to submit requests to the Charitable Giving Committee.

Name of Organization

Amount Requested

Frequency

One-time

On-going

Date of Request

YYYY

Date Required

YYYY

Purpose of Dontation

Contact Name in Organization

First Name

Last Name

Contact Number

(###)

###

####

Contact email Address

Connection with Council 11172

Connection with Saint Michael Catholic Church or Knights Council 11172 (if any):

Name of Knight Submitting Request

First Name

Last Name