Philanthropy and Volunteerism

REQUEST FORM

Volunteerism and philanthropy are a key part of the platform upon which Belterra Casino Resort & Spa was built. Through our highly visible Belterra Sponsorships program, civic engagement and support are a part of our daily culture. We consider requests in three categories:

Sponsorships seeking financial assistance for events or programs in support of 501c3 charitable organizations
Donations of in-kind contributions
Volunteerism requests for the time and talent of Belterra employees

We appreciate your request. Please review the following donation guidelines in full. Completion of this form does NOT guarantee that Belterra will be able to fulfill the request.

Effective January 1, 2010, each request must be submitted no later than 90 days prior to your sponsorship or donation deadline; those not providing ample time for consideration may limit their opportunity. Incomplete forms and those without the required documentation will be automatically denied. You may also attach other information you think relevant for our consideration via US Mail. Note that any additional information is considered supplemental only and does not eliminate the need to fill out this form in full.

Thank you again for your application; we look forward to reviewing your request!

We give special consideration to organizations or events that:

Promote the vitality of tourism and economic development in Southeast Indiana
Support law enforcement, medical research foundations, education/self-sufficiency, military
Are financially stable and well-managed
Have a history of strong community or civic support

We are generally unable to support:

Requests from individuals (such as individual medical fundraisers)
Requests from organizations that specifically benefit children under 21 years of age (public/private school fundraisers, booster groups, youth athletics)
Religious, fraternal, alumni, trade, professional or social organizations
Political or partisan organizations/candidates; or organizations established to influence legislation or special elections
Organizations that discriminate on the basis of race, religion, gender or national origin

Organization Name
Event Name
Event Location
Event Date
Sponsorship/Donation deadline
Tax ID #
IRS Status	501 (c) 3 501 (c) 4 Other (explain) Other:
Contact Name
Street
City
State
Zip Code
Email
Phone
Fax
What is the organizations primary mission?
Amount requested?
List all sponsorship levels and benefits for each level:
In-kind donation item request (hotel package etc.)?
Detailed description of how funds/items will be used:
Will there be any advertisement or promotions featuring Belterra? Please describe:
Benefits of participation by Belterra:
Are you submitting additional material via U.S. Mail?	Yes No

Belterra promotes and supports responsible gaming; Call the Indiana Gamblers Help Line 1.800.994.8448