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Donation Request Application

Optional: If you would rather download the pdf version of the Donation Request Application, fill it out, and mail or fax it to our office, please download the document here. Our mailing address and fax number are located on the contacts and locations page.

Please fill out this form completely. Uncompleted forms will be discarded.

Fields marked with * are required.

Event Information

* Date of Event:

* Event Name:

* Describe Your Event:

* Monetary Amount or Items Being Requested:

* Monetary Amount or Items Needed By What Date:

Organization Information

* Organization Name:

* Address:

* City:

* State:

* Zip Code:

* Contact Person:

* Email:

* Phone:

* Has HFFCU provided a donation for your organization in the past year?:

* Is your group/organization a nonprofit 501(c)(3)?:

* Your Comments and the best time to call:

* This is a printer friendly version of the original page, made to save you ink and paper.

Health Facilities Federal Credit Union: Our Members Are the Reason We Exist

Donation Request Application

Your savings is federally insured to at least $250,000 and backed
by the full faith and credit of the United States Government.
HFFCU is a Equal Housing Opportunity Lender.

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Donation Request Application

Event Information

Organization Information

Donation Request Application