Empire City Casino by MGM Resorts Community Engagement Support Request

Funding Request

Empire City Casino by MGM Resorts
Community Engagement Support Request

Please make sure you have read the guidelines for applying before you begin.

Each request must be submitted no later than 90 days prior to your sponsorship deadline.

All requests must be submitted online for consideration. Hard copies or email attachments are not accepted.

Organization Information

Full Legal Organization Name*

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Organization's Phone*

Organization's Website

Year Established*

Organization's Mission Statement

Geographic Area Served*

501(c)(3)*

Yes No

EIN#/Tax Identification Number*

Organization’s President/Executive Director

First Name

Last Name

Organization’s President/Executive Director Email Address

Confirm Organization’s President/Executive Director Email Address *

Name of Person Completing this Form*

First Name

Last Name

Phone Number*

Email*

Confirm Email *

Total Organization Budget*

Total # of Board Members:*

List Board Members*

Total # of Staff*

Total # of Volunteers*

Populations Served*

Note: Include age groups, race & ethnicity, income levels, etc.

Funding Type

Type of Request*

Program Support Sponsorship In-Kind

Please select one of the following and enter description below.

Sponsorship Cost or Amount Suggested*

Contribution Description*

Event or Program Information

Program/Event Name*

Event Date*

Number of people attending event*

Indicate how your program/event provides value to your target population/community*

Have we donated to your organization in the past*

Yes No

If yes, please specify years*

Donor Recognition

Please describe advertising plan and recognition that donors receive*

Please provide information about the individuals serviced by this event*

Number of people anticipated to be served in your program/agency this year*

By submitting, I acknowledge that I have read and understand the Privacy Policy (which governs the information I provide). Our California Notice at Collection of Personal Information describes the categories of personal information and sensitive personal information we collect and provides certain details about our processing of that information.

Funding Request