RPD Donation Request
Name
*
First Name
Last Name
Organization Name
*
City
*
Please Select
Rockford
Loves Park
Machesney Park
Cherry Valley
New Milford
City
*
Date donation needed by
*
-
Month
-
Day
Year
Your donation request must be received at least 4 weeks prior to when you need to receive the tickets
Daytime Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Alternate Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Organization Type
*
Please Select
Non-profit Organization (501c3)
School
If non-profit, Please provide FEIN number
*
Name of Program or Fundraising Event
*
Event Date
*
Event Date
*
-
Month
-
Day
Year
Date
How will this donation be used?
*
Please Select
Silent Auction
Raffle
Contest Prize
Other
If other use, please explain
Donation Options (select one)
*
Please Select
(4) Public Swim Admissions (valid at Alpine or Sand Park pools)
(4) Wagon Ride Admissions (valid Saturdays at Lockwood Park
(4) Sapora Playworld Admissions
(4) Public Skate Admissions (valid at Carlson or Riverview)
(4) Nicholas Conservatory & Gardens Admissions
(4) Snow Park Tubing Admissions
(4) Buckets of Golf Balls (valid at Ingersoll Golf Course)
Please note that all donation tickets will be emailed except for golf items.
Email
*
example@example.com
Mail to (Name)
*
First Name
Last Name
Mailing Address
Street Address
Street Address Line 2
City
State
Zip Code
Submit
Should be Empty: