Giving back submission form |

Giving back submission form

Written By: wildmoon

Giving back

If you're interested in participating in Mad Women Media's Giving Back program, please fill out this form. Deadlines are January 15, April 15, July 15 and October 15. We'll notify you within 10 days of those dates if you are selected. And you'll stay in our system for consideration in the next cycle. Thanks!

Group name*
Your name*
FirstLast
Your position with the group*
Email*
Phone
About your group:
The URL of your group's website, if you already have one
Does your group have a 501(c)(3)?*
What is your group's annual budget?*
Does your group have any paid staff?
How long has your group been in operation?*
Generally describe what your group does.*
Give us a couple of specific examples of your successes.*
If you have any images you'd like us to see, upload them here.
jpg, gif or png only please
Anything else you'd like us to know?
Thanks!
Please review your information, enter the CAPTCHA phrases and click submit.
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Giving back submission form

Giving back

About your group:

Thanks!

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