Donor-Advised Fund Recommendation

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Donor Fund Name:

Donor's Name: *

Donor's Email: *

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I agree to the following: *

I/we will not accept any benefits or privileges offered in connection with this grant distribution, including goods or services (including auction items); admission to charitable events; dues or memberships, other than a religious institution. The recommended grant does not represent the payment of any personal pledge or other financial obligation.

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Recommendations

Charity Recommendation 1

Name of Charity: *

Amount to Disburse (min. $100): * $

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Charity Recommendation 2

Name of Charity:

Amount to Disburse (min. $100): $

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Charity Recommendation 3

Name of Charity:

Amount to Disburse (min. $100): $

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Charity Recommendation 4

Name of Charity:

Amount to Disburse (min. $100): $

Contact Name:

Contact Phone Number:

Charity Address

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Address 2:

City:

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State:

Additional Information

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Charity Recommendation 5

Name of Charity:

Amount to Disburse (min. $100): $

Contact Name:

Contact Phone Number:

Charity Address

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Address 2:

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Additional Information

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