Donation Request

As small business owners at Crossroads Coffeehouse, we make it a priority to support a variety of local charities. Please understand that we receive a large number of requests each month and cannot honor all of them. Donations are subject to availability and are not redeemable for cash.

We earmark the majority of charitable donations to the service, non-profit, charitable organizations and benefits in the Cross Plains area and Middleton-Cross Plains Area School District clubs and sports.

Completing this form does not guarantee your request will be honored however we will make every attempt possible to fulfill your request. Thank you for your understanding.

Contact Name

First Name

Last Name

Email

Donation Request

I am looking for a donation for our local, charitable organization in the amount of:

Organization Name

Please provide the legal name and a description of the organization in which you are requesting a donation for:

Date Donation Needed By:

MM

DD

YYYY

Address

Where to send the donation:

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country