Donation Request

Please complete this form to request for funding from the Khazanski Foundation.

DISCLAIMER: Completing this form does not guarantee that you will receive funds. It is at the discretion of the founders of Khazanski Foundation to choose who receives funding.

Organization Name

Contact Name*

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Email*

Phone*

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Brief Summary Indicating Reason for Request

Identification Upload

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Max. file size: 100 MB.

At least 1 form of identification is required. (Driver's license, Passport, Business Documents)

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