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Online Donation Request Form
Fields with
*
are required.
Please Note
Chelsea Piers must receive your completed donation request, including your Donation Request Letter, no later than three weeks prior to the date of event the donation is requested for.
If you are sending the letter digitally, we accept only Word and PDF formats.
Name of Organization
*
:
Address of Organization
*
:
City
*
:
State
*
:
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
ME
MD
MH
MI
MN
MO
MP
MS
MT
NC
ND
NE
NH
NJ
NM
NY
NV
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Zip
*
:
Federal Tax ID Number:
Date of Event
*
:
1
2
3
4
5
6
7
8
9
10
11
12
/
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
/
2010
2011
2012
Title of Event
*
:
Contact Person
*
:
Contact Phone
*
:
(
)
-
Contact Email Address
*
:
Address to which donation should be sent (if different from Organization Address):
City:
State:
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
ME
MD
MH
MI
MN
MO
MP
MS
MT
NC
ND
NE
NH
NJ
NM
NY
NV
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Zip:
Has Chelsea Piers donated to your organization in the past?
Yes
No
If so, what?
How will you be sending us your letter of donation request (on company letterhead)?
Mail
Fax
Email
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