T.O.P.S. for Kids

Corporate Donor Submission Form

Corporate Application

Company Name:*

EIN:*

NAICS #:

Contact Title:

Contact Name:*

Contact Email Address:*

Phone Number:*

Fax Number:

Address:*

City:*

Zip Code:*

Accounts Payable Address is the same as above

Accounts Payable Address

Address:*

City:*

Zip Code:*

Donation Amount:*

This donation is for the corporate tuition tax credit (A.R.S 43-1183) $106,993,207 Cap

This donation is for the corporate disabled/displaced tuition tax credit (A.R.S. 43-1184) $5 Million Cap

Comments:

May we share your name and logo on our website?:*

Yes

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