CARE Application « Farmers' Mutual Insurance Company (Lindsay)

Organization name:

What is the purpose of the organization and its primary beneficiaries:

What opportunity does this request support:

Children

Healthcare

Safety

What is the donation requested for:

Charitable donation
Children’s athletic team
Community organization or event

What is the date of the event:

What is the location of the event:

What is the purpose of the event:

How will our donation be allocated:

What financial commitment you are
requesting from Farmers’ Mutual:

What date are the funds required:

Will this event recognize Farmers’ Mutual as a sponsor and how:

Contact person:

Role in the organization/event:

Address:

City:

Postal code:

Email address:

Website (if available):

Telephone number:

Please attach additional documents or information here.

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