GTel Community Support Request

Organization Name *

Tax ID *

Do you have 501(c)3 non-profit certification? *

Yes

No

Contact Name *

Title *

Organization address *

Organization address

City

State/Province

Zip/Postal

Phone *

Fax

E-mail

Please describe the purpose of your organization and its primary beneficiaries *

Program/event *

Event date

Is there a print deadline? *

Yes

No

What is the deadline? *

Do you need GTel logos or Ads? *

Yes

No

Please specify ad requirements *

How many people are expected at your event?

What cities or counties will be served?

Please describe the nature and purpose of your program and event

Has GTel donated to your organization in the last 12 months? *

Yes

No

What would you like GTel to donate to this program/event? (Be as specific as possible.) *

Has GTel donated to this program or event in the past? *

Yes

No

Has GTel already contributed to this year's program/event? *

Yes

No

Our customers like to know how we support our community. How will GTel be recognized as a sponsor of the organization/program/event? *