Military Command or Non-Profit Org Financial Assistance Request
Military Commands, Family Readiness Groups, Ombudsman, and MWR entities, or specifically referred Non-Profit (501c3's) may request financial support using this form.
Date of Request
Military Branch or Organization
Air National Guard
Army National Guard
Organization in Need
This should be your Military Command, Association or your Non-Profit Organization title.
Name of Person Requesting Donation
Please include the formal address of the Military Command or the Non-Profit Organization.
The beneficiary organization must be located in our 20-county Northeast Ohio service area. Those counties are: Ashland, Ashtabula, Columbiana, Cuyahoga, Erie, Geauga, Holmes, Huron, Lake, Lorain, Trumbull, Mahoning, Medina, Ottowa, Portage, Richland, Sandusky, Stark, Summit, and Wayne.
Description of what this donation will be used for
1. The purpose of this financial support
2. The date of the event
3. The activity to be conducted or items to be purchased
4. The number of service members and/or veterans benefiting
5. How would this support create a positive influence for the for the service member(s) or veteran(s)?
Date Needed By
PAY TO THE ORDER OF
PAYEE (if known)
NEOPAT cannot issue a check directly to a service member or individual. The Payee must be either a Non-Profit (501c3) Organization, a Military Association, an MWR account or a Business invoice that fulfills the purpose. An actual INVOICE that achieves the objective of the request is strongly recommended for fastest approval. If an invoice, it must be attached to this request.
Pay to the Order Of
Who specifically should we make the check payable to?
Payee Street Address
If you have a specific dollar amount need relating to a bill, invoice, etc, please attach it here. Up to 3 attachments may be added. Remember, specific invoices have better success!
Send me a copy of my responses
Your submission is being processed. Please do not close this browser window until complete.