Request Meeting, Community Cents, A Charity for Charities

Request for Meeting or Speaking Engagement

Nonprofit Name:		Website:

Mailing Address

City:		State:

Zip Code:	Phone:	Fax:

Executive Director Name:

Development Director Name:

Contact Name:		Contact Phone

Email Address:

Mission Statement:


Meeting Location Address:

Request Meeting with:		Staff
		Board of Directors
		Volunteers
		Speak at Meeting

Please list possibile times and dates for meeting, in order of choice:

1.

2.

3.

Please email a copy of the 501(c)(3) IRS tax-exempt status with the Counterterrorism Compliance Form (downloadable here).

Meeting & speaking engagement cannot be scheduled without these forms.

Thank you for your interest.

Julie David
Federal Tax ID#: 38-3683232