Corporate Contributions & Charitable Giving

First Name *

Last Name *

Job Title *

Company or Organization Name *

Country *

Street Address *

City *

State *

ZIP/Postal Code *

Phone *

Fax

Email Address *

Organization Website *

Please enter your 9 digit U.S. Tax ID number *

Please explain your relationship. *

What is your annual operating budget? *

Approximately how many people benefit (directly or indirectly) from the work that your organization performs in the community? *

Is your organization affiliated with a religious group? Please explain your affiliation. *

Please describe the mission of your nonprofit organization. *

Years in Existence *

Donation amount requested *

How will your organization use the contribution/donation and what locations will benefit? (e.g., raffle, award, incentive, fundraising, etc.) *

Deadline for Inclusion in Event * This deadline represents the last day your organization will consider a decision from Aptiv.

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Contact Info