Great food gives back.

Requested date of fundraiser

Organization Name

Organization Type

Organization Website

501 (c)(3) Tax ID Number

Contact Name

Email Address

Phone Number

Check Made Payable To:

Donation Check: Address where we should send it?

City

State

ZIP

Use of Proceeds from Event

Other information we should know about your organization and event:

Have you submitted a request to Baja West Coast Kitchen in the past 24 months?

• Yes
• No

How did you hear about Baja Fundraising?

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If other, please specify:

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