Request for Donation

* Denotes required field  
Event Date:  Event Location:  
Organization Name:    Organization Type:  
Organization/Event Website:   Other Organization Type:  
Charity Number:   Contact Name:  
Contact E-mail Address:   Contact Phone:  
Contact Address:  
Province:   Postal Code:  
GPP or Fundraising Customer ID:      

Please describe what the event is about,
and who (if any) the beneficiaries are:  
Please describe the kind of recognition (if any)
that will be provided for Purdy's by contributing to this event:  

Expected # of People:  

Where would you like to pick up the donation?  
What type of donation are you looking for?  
I'd like to learn more about fundraising
opportunities using Purdy's Chocolates  
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or any other use. For more details, please see our Privacy policy.