Corporate Online Form

Corporate Income Tax Credit Application

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Corporation Name*

Company Type:*

C-Corporation

S-Corporation

Insurance Company

NAIC #:

Corporate Street Address*

Corporate Street Address City State Zip Code

Contact Name and Title:*

Phone*

Email*

Corporate EIN*

Name and EIN of parent S corporation if contributing company is a qualified subchapter S subsidiary

Amount the corporation is requesting to donate $*

Release of Information*

Please let us know if you permit us to share information about your contribution.

Yes, you may release our identity and contribution amount.

Yes, you may only release our identity.

We prefer that our participation be kept entirely confidential.

Corporate Partnership Opportunities*

If you would like to partner with the Brophy Community Foundation, help us expand our mission, and give your company brand exposure, please check any of these opportunities.

Check Presentation

Testimonial Quote

Social Media Posts (Facebook, Instagram, LinkedIn)

Event Speaker

Newsletter Story

Engage with our BCF Internship Program

Other (Laura GIesecke will follow up)

None

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