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Zappos Donation Request Application

We appreciate your interest in Zappos.com and your commitment to helping others. Please fill out all fields. Upon review, if we determine your request fits within our current giving program, Zappos will contact you for additional information.

Proposal Information

Name of Proposal: *

Proposal Abstract: *

Please provide a brief abstract of your proposal. (250 characters max)

Organization Information

Organization/Agency Name (Chapter Name): *

Organization/Agency Mission: *

Are you in possession of a 501(c)3 determination letter?: * - Select -YesNo

Upon reviewing your application, a copy of your 501(c)3 Determination Letter will be requested along with your 501(c)3/Tax ID Number (EIN).

Are any Zappos employees involved with your organization?: * - Select -YesNo

Organization Focus:

So that we may track areas of special interests, please mark the segments that are closely associated with your organization's focus. This information is for reporting purposes only and is not required.

Please select your organization focus:

Health

Education

Environment

Arts

Science

Poverty

Animal Rights

Human Rights

Religion

Housing

Other (Please Specify Below)

If other, please specify:

Primary Contact Information

Name: *

Association with Organization?: *

Address: *

City: *

State: *

Zip Code: *

11111-0000

Phone: *

123-456-7890

Email: *

Website:

Twitter:

Facebook:

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