Apply to be our Charity of the Month! Either fill out the online application below or print out our PDF application and send it into us.

Please complete this application to be considered for our Charity of the Month. All fields are required for submission; if a field does not apply to you, please denote that.

Name of the organization:

Mission of the organization:

Specific activities of the organization to help chosen population:

Geographical area served:

501(c)(3) status / tax ID:

How do you use donations?:

What percent of donations go to aid the chosen population?:

How did you hear about The Modified Dolls?

Contact name for the organization:

Contact E-mail:

Contact Phone:

By checking this box, I allow The Modified Dolls to use the organization's name and logo in order to promote events and raise awareness. (Either attach a high resolution logo below or e-mail to info@themodifieddolls.org or contact us for more options)

Attach a high-resolution image of your organization's logo (Image size limit: 4MB):


By signing below, I attest that I have the authority to submit this application on behalf of the above organization. I understand that even though I am submitting this application, the organization is not guaranteed to be selected as The Modified Dolls' Charity of the Month. If the above organization is selected as Charity of the Month, should any of the above information change prior to its selected month, I will update The Modified Dolls immediately.



Signature / Title of authorized representative



Date

I consent to having this website store my submitted information so they may review my application.