Donation Request Form

Request a Material Donation for Your Organization

Organization Name*
Description of your organization
Is your organization a 501(c)(3) nonprofit organization?*
Primary Contact Name*
Primary Phone*
Primary Email
Address*
Date(s) of project
Did your organization provide a budget for this project? If so, how much? *
Description of your project
Description of expected community benefits
What type of donation would you like to receive?
If "Other" Please explain
If asking for credit, what kind of materials will you be looking for?
To help SCRAP document the community benefits of its donation and promote reuse projects, we ask donation recipient to provide a very brief report, ideally with photos we can use. are you willing to submit this report? *
Some of our SCRAP Gives Back funds are sponsored by grants from various support organizations. The following questions are voluntary, but help us know how our materials and funds are best supporting our community. We appreciate your participation
1) Which of the following ranges includes the typical age range of the community you serve? (Select all that apply)
Under 18:
18-24:
35-44:
45-54:
55-64:
65-74:
75 and older:
Prefer not to answer:
2) Within the broad categories below, where would you place the racial or ethnic identity of the community you serve? (Select all that apply)
Native American, American Indian, or Alaskan Native:
Asian or Asian American:
Black or African American:
Hispanic or Latino/a/x:
Native Hawaiian or Pacific Islander:
White/Caucasian:
An ethnicity not included above (please specify):
Prefer not to answer:
3) How do you identify the gender of the community you typically serve? (Select all that apply)
Woman:
Man:
Transgender Woman or Transgender Man:
Non-binary, Genderqueer, Two-Spirit, or Third Gender:
A gender not listed above (please specify):
Prefer not to answer:
4) Does your community navigate life with a disability?
Yes:
No:
Prefer not to answer:

Thank You!

619 SE 6th AVE, Portland, OR 97214
503-294-0769

SCRAP is a 501(c)(3) nonprofit organization, Federal Tax ID 93-1270807. Donations are tax deductible as allowed by law.

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Donation Request Form

Request a Material Donation for Your Organization

Some of our SCRAP Gives Back funds are sponsored by grants from various support organizations. The following questions are voluntary, but help us know how our materials and funds are best supporting our community. We appreciate your participation

1) Which of the following ranges includes the typical age range of the community you serve? (Select all that apply)

2) Within the broad categories below, where would you place the racial or ethnic identity of the community you serve? (Select all that apply)

3) How do you identify the gender of the community you typically serve? (Select all that apply)

4) Does your community navigate life with a disability?

Thank You!

619 SE 6th AVE, Portland, OR 97214 503-294-0769

619 SE 6th AVE, Portland, OR 97214
503-294-0769