Donation Request Form

Submit form and related information to: Arvig
℅ Donations Committee/Josie Winkels
150 Second Street SW
Perham, MN 56573
Fax: 218.346.8829
Email: Josie.Winkels@arvig.com

All donation requests must be submitted a minimum of sixty (60) days in advance of the date that the donation is needed. Responses may take as long as two weeks to process once the donation is approved. Please note: due to state and federal regulations we are unable to waive taxes and fees associated with donated service.

Requestor Name *

Date of Request *

Month Day Year Date Picker Icon

Company/Organization Represented *

Make check payable to *

Send to *

Phone Number *

Email *

Date of Event *

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Date Needed *

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Reason for Request *

How will Arvig be recognized for this event? *

How many Arvig customers will be impacted by this donation? *

Additional Information *

Donation Requested *

Flyer and/or More Information

For Internal Use Only

Donations Committee Approval _____________________________________

Date __________________________________________________________

Amount _______________________________________________________

Or Item ____________________________________________ ____________

AP Invoice # ________________________________________________________

Coding
Arvig Ent/Birch 191.7181
Callaway 426.7181.7300
MIS 1710.7181
Redwood County 250005.7181.7300
Melrose 191005.7181.7300

EOT 229.7181.7300

Osakis 1210.7181.7300

Home 151005.7181.7300

Clements 260005.7181.7300

TCS/PR/Tek 627.7181

Midwest Telco 1110.7181.7300

Southern Cable 152005.7181

TVU 318.7181.7300

People 1610.7181.7300

Martinsen 150005.7181

Mainstreet 192005.7181

Marketing 115.7181

Felton 515005.7181.7300

Eagle Valley 550005.7181.7300

Loretel 513005.7181.7300

Alliance 5510005.7181

Arrowhead 540005.7181.7300

Golf 115-7181/9133