Pirate Toy Fund

Toy Category Quantity Used? Notes (if necessary)

Infant (0-2)

Toddler Boys (3-5)

Toddler Girls (3-5)

Boys (6-10)

Girls (6-10)

Teenage Boys (11-14)

Teenage Girls (11-14)

Will you accept Christmas/Easter-branded toys?

Yes

No

Is this a toy request for the holidays?

Yes

No

If “Yes”, what date do you need them by?

Program Partner:

For what Program Partner are you requesting toys?

Toy Category Quantity Used? Notes (if necessary)

Infant (0-2)

Toddler Boys (3-5)

Toddler Girls (3-5)

Boys (6-10)

Girls (6-10)

Teenage Boys (11-14)

Teenage Girls (11-14)

Will you accept Christmas/Easter-branded toys?

Yes

No

Is this a toy request for the holidays?

Yes

No

If “Yes”, what date do you need them by?

Toy Category Quantity Used? Notes (if necessary)

Infant

Toddler Boys (3-5)

Toddler Girls (3-5)

Boys (6-10)

Girls (6-10)

Teenage Boys (11-14)

Teenage Girls (11-14)

Will you accept Christmas/Easter-branded toys?

Yes

No

Is this a toy request for the holidays?

Yes

No

If “Yes”, what date do you need them by?

Organization Information

Tell us more about your organization.

Organization name (legal name) *

If known by another name or acronym, please indicate

Name of parent organization, if applicable (i.e., scout troop or school district)

Organization Address:

City:

State:

ZIP Code:

Organization's Main Phone #:

What is the URL of your organization's website?

Is your organization an IRS non-profit or public tax-exempt organization (e.g., schools, churches) as defined under Section 501(c)? *

Yes

No

What is your federal taxpayer ID number? *

Year organization founded?

What is your organization's mission? *

What county or counties does your organization serve? *

Executive Director's First Name *

Executive Director's Last Name *

Executive Director's Phone # *

Executive Director's Email Address *

Primary Contact

Your organization's Primary Contact will be the sole liaison between your organization and the Pirate Toy Fund regarding your requests for toys. If this person changes, you'll need to contact the Pirate Toy Fund's Program Coordinator in order for your program to continue receiving toys.

Primary Contact's First Name *

Primary Contact's Last Name *

Primary Contact's Phone # *

Primary Contact's Email Address? *

Toy Needs

Tell us how will you use our toys.

How did you hear about the Pirate Toy Fund?

Is your organization receiving toys from any other source (e.g., another organization, a toy drive, individual donations, etc.)? *

Yes

No

Has your organization been a Pirate Toy Fund Program Partner in the past? *

Yes

No

When does your organization plan to distribute toys received from the Pirate Toy Fund? *

Year-Round

Holiday season (Nov-Dec)

Summer camp/retreat or similar

Other (Please describe)

If you selected "Other" please describe.

Will ALL of the toys you receive from the Pirate Toy Fund be distributed during a specific event? (e.g., a holiday party, an awards ceremony, camp, etc.) *

Yes

No

If you answered yes, what is the required date for the toys?

How many children does your organization serve annually? *

NUMBER OF TOYS REQUESTING ANNUALLY FROM THE PTF
AGE GROUP	Number of toys needed annually
Infant (0-2 years) *
Toddler Boy (3-5 years) *
Toddler Girl (3-5 years) *
Boy (6-10 years) *
Girl (6-10 years) *
Teen Boy (11-14 years) *
Teen Girl (11-14 years) *

How will you promote the Pirate Toy Fund (i.e. mentions/links via social media, website, newsletters, ads, etc.)? *

Your Account Information (if accepted)

Set up Your account information in case we accept your application.

Account email address *

Account organization name *

Account representative name *

Account contact number *