Basil Online Donation & Contribution Request Form

In order to serve you better and quicker please ensure that the form is completely filled out. All requests must be made through this form, phone calls & in person requests will not be accepted.

Please Choose a Location:









Event our donation is being requested for:
Start: End:

Briefly describe for us how the contribution we provide will be used:
Explain what type of contribution you prefer (ie: check, services, gift certificates)
Please select your organization type:


Are you a tax exempt 501(c)(3)? If yes, what's your Fed Tax ID #:
May we use your name for publicity purposes? Do you wish to remain anonymous?
Are you or your organization a customer of Basil? If so, please describe?
Has an employee referred this request or been involved with your organization as a contributor, volunteer, or director?
I affirm that all the information above is true and acurate