Auction Items and Card Donations

Online Request Form

(* Required)

Name of Organization:*

City:*

Zip Code:*

Contact person First Name:*


Daytime phone:

- -

Organization address:*

State:*

Organization website:

http://

Contact person Last Name:*

Email address:*
(must be provided, responses will be sent via email)



Organization type: (select one)


Service Club
College or University

Association
Community Event
Other

Note: The Casino does not donate to K-12 schools, churches, businesses, individuals or third-party fundraisers.

Giving Category: (select one)


Sustaining the Environment
Celebrating Diversity

Supporting Elders
Economic Development
Other

 

Note: Gifts to meet the needs of children are made exclusively through the Miracle on Canal Street program.

What is being requested: (select one)

Auction Item Decks of Cards Other

Name of event/activity:

Date of event (MM/DD/YYYY):

Is event located within 100 miles of Potawatomi Bingo Casino? yes No

Background information about event (limited to 500 characters):


Number of people attending event:

Will people under age 18 be attending this event? yes No

Additional details (limited to 500 characters):

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