Request a donation

Please complete the online form below and submit. Note: Your completed application must be received at least 30 days in advance of your donation deadline to be considered. It is not necessary to send a procurement form. Please submit your request at least 30 days before your procurement deadline. Donation requests are limited to $100 in value per instance. Please select your neighborhood location and refrain from submitting requests to multiple stores. Donations must be picked up by a member of the recipient organization in person at the PCC store location selected.

Please read PCC’s donation guidelines prior to filling out application.

Your contact information
Name*
First Last
Phone*
Email*
How are you involved with this organization?*
Organization information
Organization name*
EIN*
Phone*
Address*
Street Address Address Line 2 City State ZIP Code
Organization's purpose or mission statement*
Donation information
PCC Store*
Choose the PCC store that you are requesting a donation from.
Date needed*
Date should be at least 30 days from today.
MM slash DD slash YYYY
Item requested*
Detailed description of what you are requesting a donation for*
In detail, how will PCC's donation be used?*
Guidelines*
- I have read and understand the guidelines for a donation request.

Request a donation

Your contact information

Organization information

Donation information