Roseburg Gives Back

Requests can take up to 90 days to process. You will be notified if your request is approved. Please submit additional supporting documents to [email protected]. Thank you.
Organization Info
Name of Organization*
Best Contact Person*
Title*
Email*
Phone*
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Website*
Founding Date*
Mission*
Geographic area served*
Tax ID (EIN#)*
Is the Organization a 501(C)(3)*
- Yes
- No
Have you received support from Roseburg in the past?*
- Yes
- No
If yes, please indicate amount of prior contribution/material*
Have you submitted the current request to a Roseburg mill?*
- Yes
- No
If yes, please indicate which mill*
Are you or someone affiliated with the applicant organization a Roseburg employee?*
- Yes
- No
If so, at which location*
Event/Activity Information
Name of event/activity*
Date*
Date Format: MM slash DD slash YYYY
Location*
Approximate number of people served or involved*
What percentage of the funding will be used for administrative costs?*
Describe how this event/activity ties in with our focus areas listed under our Eligibility Guidelines*
Requested dollar amount/in-kind support*
Date by which fund/services are requested*
Date Format: MM slash DD slash YYYY
What recognition will Roseburg receive for the sponsorship?*
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Phone
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Organization Info