PTF Program Partner Application

Pirate Toy Fund Program Partner Application Form

The Pirate Toy Fund distributes new toys to children in need throughout the Greater Rochester region year-round through our Program Partners. Our Program Partners support children affected by medically traumatic issues, domestic abuse, natural disaster, and the financially disadvantaged.

For your application to be considered, all fields must be filled out to the fullest.

Fields with * are required.

Basic Information

Tell us how will you use our toys.

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

Yes

How did you hear about the Pirate Toy Fund?

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

If you answered yes, what are the approximate date(s) of the event?

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)

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

Yes

What is your federal taxpayer ID number? *

What is the URL of your organization's website?

Year organization founded?

What is your organization's mission? *

What county or counties does your organization serve? *

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

How many children does your organization serve annually? *

How many toys are you asking for from the Pirate Toy Fund 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.)? *

Executive Director's First Name *

Executive Director's Last Name *

If the person in charge of your organization is not referred to as the "Executive Director," what is his/her official title?

Executive Director's address (for mailing) *

Executive Director's City *

Executive Director's State *

Executive Director's Zip Code *

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 Job

Address1? *

Address2 (if necessary)

City *

State *

ZIP Code *

Primary Contact's Phone # *

Organization's Main Phone # *

Primary Contact's Email Address? *

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 *

Account password *

Account password repeated *