Donation Request Form Template

<form action="https://splitforms.com/api/submit" method="POST">
  <input type="hidden" name="access_key" value="YOUR_ACCESS_KEY">
  <input type="hidden" name="subject" value="New donation request">
  <input type="hidden" name="form_loaded_at" id="form_loaded_at">

  <fieldset>
    <legend>Your organization</legend>
    <label>Organization name
      <input type="text" name="org_name" autocomplete="organization" required>
    </label>
    <label>Type of organization
      <select name="org_type" required>
        <option value="">Choose one</option>
        <option>Registered charity or nonprofit</option>
        <option>School, PTA or parent group</option>
        <option>Sports team or club</option>
        <option>Community group (not registered)</option>
        <option>Individual fundraiser</option>
        <option>Other</option>
      </select>
    </label>
    <label>Charity registration number, if registered (as shown on the public register)
      <input type="text" name="registration_number">
    </label>
    <label>Contact name <input type="text" name="contact_name" autocomplete="name" required></label>
    <label>Email <input type="email" name="email" autocomplete="email" required></label>
    <label>Phone <input type="tel" name="phone" autocomplete="tel"></label>
  </fieldset>

  <fieldset>
    <legend>What are you asking for?</legend>
    <label><input type="radio" name="request_type" value="Cash donation" required> Cash donation</label>
    <label><input type="radio" name="request_type" value="Products or gift cards"> Products or gift cards</label>
    <label><input type="radio" name="request_type" value="Raffle or auction item"> Raffle or auction item</label>
    <label><input type="radio" name="request_type" value="Services or volunteer time"> Services or volunteer time</label>
    <label><input type="radio" name="request_type" value="Venue or equipment"> Venue or equipment</label>
  </fieldset>

  <label>Describe the request (item, quantity, or amount)
    <textarea name="request_details" rows="3" required></textarea>
  </label>
  <label>Estimated value, in whole dollars
    <input type="number" name="estimated_value" min="0" step="1">
  </label>
  <label>Who benefits, and how will the donation be used?
    <textarea name="purpose" rows="4" required></textarea>
  </label>

  <fieldset>
    <legend>Event and timing</legend>
    <label>Event or campaign name <input type="text" name="event_name"></label>
    <label>Event date <input type="date" name="event_date"></label>
    <label>Date you need a decision by <input type="date" name="decision_needed_by" required></label>
  </fieldset>

  <label>How would you recognize the donation, and roughly how many people would see it?
    <textarea name="recognition" rows="3"></textarea>
  </label>

  <label><input type="checkbox" name="guidelines_ack" value="yes" required>
    I have read the donation guidelines on this page.</label>

  <!-- honeypot: leave empty -->
  <input type="checkbox" name="botcheck" style="display:none" tabindex="-1" autocomplete="off">

  <button type="submit">Send donation request</button>
</form>
<script>
  document.getElementById('form_loaded_at').value = Date.now();
</script>