The Butte County Deputy Sheriff Association Board of Directors are requiring the following information for any consideration for donations. Please complete this form and submit your request. You may be asked by the BCDSA Board of Directors to supply an additional outline of your request on your organization letter head if needed.

          Please provide the following contact information:

First Name
Last Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Work Phone
Home Phone
E-mail

         Amount of Donation Requested ... ?

         Check payable to (If approved):

         Donation For: (Please explain in Detail)

         How will this donation benefit our local community?