donation request letter - Liberty Vineyards & Winery

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DONATION POLICY!
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Liberty Vineyards & Winery is active in our local community and committed to supporting a
number of charitable activities. Each year we donate wine, gift cards, gift baskets and time to a
number of local and charitable organizations!
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Due to the high volume of donation requests received (usually at least 1 request per day), we
are unable to make large donations to every organization (we wish we could as almost all of the
requests we receive are for worthy causes). To maximize our charitable efforts,we are able
to offer wine tasting or private tour and wine tasting certificates for a variety of non-profit
charitable organizations, but our larger donations are reserved for a number of charities
with whom we have a long-standing relationship or those that are especially close to our
hearts and those of our employees, family and friends. We proudly support a number of
organizations including: Sheridan Volunteer Fire Department, the Child Advocacy Program, The
Resource Center Foundation and the National Multiple Sclerosis Society.!
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We are especially proud to support the Facial Pain Research Foundation (FPRF), an
organization dedicated to finding a cure for Trigeminal Neuralgia and other neuropathic
pain conditions. Trigeminal Neuralgia is an extremely painful condition affecting the Trigeminal
Nerve, which carries sensations from the face to the brain. Trigeminal Neuralgia is considered
one of the most painful conditions known to mankind and causes severe, electric-shock-like
pain in the face, which is triggered by everyday tasks like washing your face, talking, chewing,
drinking, brushing your teeth, applying makeup, and more. Even a light breeze can cause
patients to feel lightning-like bolts of pain in their face. Our daughter, Beth, the marketing
manager here at the winery, developed this condition in 2003, and is still in pain after three brain
surgeries and numerous other treatments. Research for a cure is something very near and dear
to our hearts, and therefore much of our charitable activities are focused on the FPRF.!
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If you are interested in securing a donation for your organization, please fill out the
Donation Request Form on the reverse. Please also submit a donation request letter on
your organization’s official letterhead. Submitting a donation request form does not
guarantee a donation. Liberty Vineyards & Winery is not able to donate cash and can not deliver
donated items. Donated items must be picked up at the winery during normal business hours.!
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Thanks for your interest in Liberty Vineyards. We wish you all the best with your charitable
activities.!
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Sincerely,!
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Gary and Pam Burmaster!
Liberty Vineyards & Winery!
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DONATION REQUEST FORM!
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!ORGANIZATION TYPE: (circle one) NON-PROFIT or FOR PROFIT (donations are usually only
ORGANIZATION NAME: _____________________________________________________!
granted to registered non-profit organizations)!
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Non-Profit Organizations: Are you a registered 501c3 organization? YES or NO (circle !
one)!
(If yes, please provide completed ST-119.1 form from the NY State Department of !
Taxation and Finance)!
!NAME & TITLE OF CONTACT PERSON: !
_________________________________________________________________!
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PHONE NUMBER: ___________________________________________________!
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E-MAIL ADDRESS: ___________________________________________________!
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MAILING
ADDRESS:___________________________________________________________________!
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EVENT INFORMATION (if applicable)!
NAME OF EVENT: ____________________________________________________________!
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DATE OF EVENT: _________________________________!
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BRIEF DESCRIPTION OF EVENT/HOW DONATION WILL BE USED (EX. RAFFLE PRIZE):
________________________________________________________________!
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Our standard donation is a certificate for a free wine tasting for up to 6 people. If this
donation will not work for your event, please state what you would like to request and
why:
________________________________________________________________!
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SIGNATURE: _________________________________________________________(by
signing you agree to abide by applicable laws and agree to only give wine to those above 21
years of age)
LIBERTY VINEYARDS USE:!
ITEM DONATED: ____________________________________ DATE: ____________!
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SIGNATURE: _________________________________________________________