Donation Request Form
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Email *
Date of Application
 *
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DD
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YYYY
Name of Organization
 *
Contact Name - First
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Contact Name - Last
 *
Contact Phone Number
 *
Contact Email
 *
Type of Organization - check all that apply to your primary mission *
Required
If other, please specify
Is your organization a 501 C-3?
 *
Have you received any donations from Chatham Marketplace within the last year?
 *
Round Up Program Updates
Please note that as of 2024 our Round Up program has shifted it's focus. Chatham Marketplace is now partnering with a static group of non-profits that combat food insecurity in Pittsboro and greater Chatham County. We value our connections with previous Round Up partners and hope you will reach out if there are other ways Chatham Marketplace might support your work, such as in-kind donations for special events.  
Type of Donation Requested
 *
Required
Details about your request
 *
Public recognition Chatham Marketplace will receive:
 *
Is this for an event?
 *
If yes, please list the date of the event or when the donation would be needed:
A copy of your responses will be emailed to the address you provided.
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