REQUEST FOR DONATION

Energy Weldfab is committed to supporting high-impact initiatives and organizations to help build stronger communities for the future. Please fill out the form below if your organization would like to request funds from Energy Weldfab.

Name of Organization

Contact Name

First Name

Last Name

Contact Phone Number

Email Address

Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Type of Organization

Tax Exempt?

Amount Requested

How would the requested donation be used?

Additional Comments (optional)

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