Donation Request

The Museum of Life and Science is happy to support community events through the donation of a family pass.  Non-profit organizations and schools can use this form to request a donation for either a door prize or raffle prize benefiting their organization.  Family passes permit up to five people a full day's access to all Museum exhibits and are good for one year from issue.

Organization Name: *

Event Name: *

Type of Organization: *

Event Date: *

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Your Name: *

Your Email Address: *

Address: *

The pass will be sent to this address.

City: *

State: *

Zip Code: *

Contact Name: *

Tax ID Number:

If applicable

Comments:

Would you like to join our Email list to receive occasional news and announcements from the Museum?: *

Yes

No