CCCWC Donation Request Form

1. Donation Requests
The Central CT Community Women’s Club is a non-profit organization which supports civic,
educational, recreational and social needs of the following communities: Cromwell, Berlin,
Middlefield, Middletown, Newington, Rocky Hill, and Wethersfield. Below are some examples
of past club donations:
 All area Public Libraries;
 Elementary, intermediate, middle and high schools;
 CHS Music Boosters;
 Boy Scouts and Girl Scouts;
 Scholarships for area high school seniors;
 Park and Recreation Department;
 Food Bank;
 Fuel Bank;
 Cromwell Senior & Human Services Department;
 Cromwell Senior Center;
 ECS/WIS Playground Fund;
 Jensen’s Fun Day and Sir Jensen’s Court at Pierson Park;
 Greater Middletown YMCA Strong Kids Campaign;
 Connecticut Junior Women, Inc. charitable programs.
Our annual club donations are allocated at the end of our fiscal year in May. If you or your
organization would like to apply for consideration for a donation, please complete and submit
the attached Donation Request Form.
Central CT Community Women’s Club P.O Box 50 Cromwell, CT 06416
www.centralctcommunitywomensclub.com

2. Donation Request Form
www.centralctcommunitywomensclub.com
Organization/Individual Requesting Donation: _____________________________________________
Contact Name: _________________________________________________________________
Address: _________________________________________________________________
Phone Number: _________________________________________________________________
eMail Address: _________________________________________________________________
Amount Requested: _________________________________________________________________
Describe the need this request will meet: _________________________________________________
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Do you or your organization have other means of soliciting funds? If yes, please describe: __________
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All submissions are due by April 15th
. To submit this Donation Request, send the completed form to:
Central CT Community Women’s Club
Attention: Donations
P. O. Box 50
Cromwell, CT 06416