All-in 4 Change Donation Request Form

PRE-QUALIFICATION

*Organizations MUST MEET the following criteria in order to enter the All-in 4 Change contest:

Required*

1.) Does your organization have a location in San Diego, Riverside or Orange Counties?

是的

不

2.) Is your organization an educational institution or registered not-for-profit charity? Is your organization classified as tax-exempt under the US IRS section 501(c)(3), classified as a public charity under Section 509(a)(1), (2) or (3), or a public university (170c1)?

是的

不

3.) Is your organization a religious organization?

是的

不

4.) If funded, will this grant remain under the financial control of the applying organization and not be re-granted in any way to other charitable organizations?

是的

不

5.) Does your organization emphasize one of these focus areas?

是的

不

Education: Pre-schools, K-12 and colleges and universities, continuing adult education, vocational/technical, or organizations furthering education around issues

Environment: Organizations that promote or address environmental sustainability, energy efficiencies, carbon reduction, water/waste/energy conservation and responsible stewardship of natural resources

Health and Wellness: Organizations that aim to find cures for or support those living with diseases and promote healthy living

Military and Veterans: Provides support to active, reserve, and veteran servicemembers

Older Individuals: Organizations that focus on helping individuals 55 and older live more fulfilling lives

6.) Does your request include naming, branding and/or media opportunities?

是的

不

7.) Does your request demonstrate diversity by providing services and volunteer opportunities to all without regard to race, ethnicity, gender, religion, sexual orientation, gender identity or disability?

是的

不

8.) Is the request legal and ethical under local laws and practices and not designed or intended for an improper purpose?

是的

不

9.) If funded, will this grant be used to improperly influence a Government Official or any individual, or in explicit or implicit exchange for improper favors or benefits?

是的

不

10.) In addition to the grant, are you requesting support for employees to volunteer with your organization?

是的

不

11.) Have you received support from Harrah’s Resort Southern California, Caesars Entertainment, or the Caesars Foundation in the past?

是的

不

11a.) If yes, what year did you receive support?

11b.) If yes, what dollar amount of support did you receive?

Leave blank if not applicable.

12.) Is an employee of Caesars supporting this request or were you referred by a Caesars/Harrah’s Resort Southern California employee?

是的

不

13.) Which county (IES) will the grant be supporting?

14.) Enter your organization’s mission statement or purpose for the grant

15.) If grant is being requested for a specific event, how many people are expected and what (if any) is the fundraising goal?

Is there anything else you would like to tell us that you believe would assist in evaluating your organization?

How did you hear about All-in 4 Change?

First Name

Last Name

Cell Phone

Company Name

Tax ID (EIN Number)

Address

Address Line 2

City

State

Zip Code

Company Website

Leave blank if not applicable.

Company Facebook

Leave blank if not applicable.

Company Twitter

Leave blank if not applicable.

Company Instagram

Leave blank if not applicable.

Upload A Completed W-9 Form (with proof of tax status)

Upload Your Company Logo

Logo Specifications: Background: Light grey, Hex value: #f6f6f6. Canvas size: 1480 × 966 px. File format: PNG or JPG preferred. 72 dpi. RGB color mode. Click here for an example.