Mike Molstead Motors is dedicated to supporting the communities it
serves. Mike Molstead Motors believes it is important to individually
address each contribution request. However, because of the literally hundreds of requests that we receive Mike Molstead Motors has established the following required contribution request form. To request a donation from Mike
Molstead Motors, please review the form provided below.
Request Forms can be mailed or e-mailed to:
Mike Molstead Motors
Attn: Amy Stoeffler
1501 South Grand Ave
Charles City, IA 50616
Email: amy@mikemolsteadmotors.com
Organization Name: _____________________________________________
Address: _______________________________________________________
County: __________________City:____________________ State:_____ Zip:_____
Telephone: (___) _____-_____ Fax: (____) ______-______
Type of Organization: (please check one)
____Animal Welfare ____Church ____Arts & Culture
____Civic & Community _____Government/Military ____Athletic
____Education _____Business ______Health & Human Services
____Environment/Agriculture
Tax Exempt#/501c3 (attach documentation) ____________
Contact Name: ___________________ Contact Telephone (______) _____-______
Event Date: _____________ Event Name:_________________________________
Event Location: ______________________________________________________
Description of Event: __________________________________________________
Item to be used for: (Please check one)
Door Prize: ________ Incentive: ________ Silent Auction:_______
Raffle:_____
Live Auction: _______ Other: ________________
Donation Shipping Address: _____________________________
Attention: ___________________________________________
Address: ____________________________________________
City, State, Zip_______________________________________
We give back because we can, because we care and because we believe that
everyone doing a little can accomplish a lot. Enhancing the lives of those
around us is both a responsibility and a privilege.
Has your organization made a request in the last 12 months?_________