Gift Match Request Form

EMPLOYEE INFORMATION

Your Name (required)

Your Email (required)

Phone Number

Hire Date (mm/dd/yyyy)

GIFT INFORMATION

Gift Amount ($)

Requested Match ($)

Date of Gift (mm/dd/yyyy)

GRANTEE INFORMATION

Name of Organization

Full Mailing Address

Email Address

Phone Number

EIN/Tax ID Number

By checking the box you agree to authorize Wimmer Solutions to collect your inquiry and or correspondence data for record keeping and process it to communicate with you

We will treat your personal data carefully in accordance to our Privacy Policy