Matching Donation Request Form

Member One matches employee donations to 501(c)(3) organizations that do not have a religious or political affiliation. If a Member One employee informs you that they have made a qualifying donation to your organization, please fill out our Matching Donation Request Form below.

Name of Donor (Member One Employee)

Amount of Donation

Date of Donation

Name of Nonprofit

Is the Nonprofit a religious or political organization? YesNo

Is your organization a government sanctioned tax-exempt organization under section 501(c)(3) of the internal revenue code (or similar code sections), or a sanctioned state or local governmental agency? (nonprofit organization) SanctionedNon-SanctionedNot Applicable

Full Mailing Address

Phone Number

Upload any additional information

External Site

Matching Donation Request

Matching Donation Request Form