Donation Request Form

Ashcroft Vision Care supports many charitable organizations every year. Charitable requests should be made well in advance of any fundraising activity. Please understand that we cannot accept every request for support. If you do not receive a donation within two weeks of your request, Ashcroft Vision Care was unfortunately not able to accommodate your application.

Please complete the following and submit a minimum of one month prior to your event;

Name of Charity(*)

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Please provide a brief description of Charity or charitable event:(*)

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Date donation required(*)

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Are you a registered charity?(*)

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Do you issue a charitable receipt?(*)

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Contact Info:

Contact Person’s Name(*)

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Mailing Address(*)

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Phone #(*)

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Email:(*)

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(*)

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Donation Request Form

Dauphin Office

Roblin Office