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First name

Last name

Email*

Phone number

Relationship to Croptimistic

Client

Service Provider

Staff Member

Community Member

Donation Request Type

Cash

Swag

In-Kind (Volunteer, Representative)

Other

If Cash Selected, Amount Requested

Does this Impact One of the Following Communities?

Naicam, SK, Canada

Humboldt, SK, Canada

Yorkton, SK, Canada

Saskatoon, SK

Edmonton, AB, Canada

Kelowna, BC, Canada

Brandon, MB, Canada

Des Moines, IA, USA

None or N/A

Will a Tax Receipt be Available?

Yes

No

Sponsorship Request Message

Please upload any supporting documents. (e.g. Sponsorship letter, event information, etc.)

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