Donation Request Form

Thank you for your interest in Husar’s House of Fine Diamonds as a prospective contributor to your organization. To be considered, please fill out the form below. A Husar's representative will be in contact with you shortly.

Items marked with an asterisk (*) are required.

Your Information
* Contact name
* Phone number
* E-mail address
About Your Organization
* Organization name
* Organization address
Non-Profit tax ID
Website
* Your organization's mission
Has your organization received a donation from us in the past?
About the Donation
* Name and type of event at which the donation will be used
* Event date
* Approximate number of people attending
* Goal of the event
Approximately what percentage of the event's proceeds will go towards the cause?
* What will the donation be used for? (e.g., auction item, raffle, etc...)
* Type of donation (item) requested
Would the donation involve a display or signage? If so, please describe.
* Will Husar's House of Fine Diamonds be the exclusive jeweler for this event?
Anything else you would like us to know?
Pickup Information
Please provide the following information. If your donation is approved, we will need to know how you wish to pick the item up.
Pickup date
Name of person picking item up
Phone number of person picking item up

 
footer
E-Mail: info@husars.com Phone: (262) 334-3453 Toll Free: (800) 852-0457
131 North Main Street, West Bend, WI 53095 | Map | Store Hours
© Husar's House of Fine Diamonds
Join us on Facebook