Request for New Organization Record - South Dakota School of Mines and Technology

Use this form to request that a new database record be created for an organization. The following information is required in order to create a Raiser's Edge record in which to store actions and contact information. Please complete this form and submit. Thank you.

ORGANIZATION RECORD REQUEST FORM

INSTRUCTIONS

To request a new record for an organization, please complete the required fields below. To request a new individual record for a person, please complete a separate INDIVIDUAL RECORD REQUEST FORM.

ORGANIZATION INFO

Company Name:*

Company Street Address:*

Company City:*

Company State:*

Company ZIP:*

Company Email:

Company Phone:

Primary Company Contact Name:*

Primary Contact Title*

Primary Company Contact Phone:*

Primary Company Contact Email*

WHY SHOULD THIS CONSTITUENT BE IN OUR DATABASE?

Constituent Coding:

Company

Foundation

Notes:

REQUESTED BY:

Your Name*

Your Phone Number:*

Your Email Address:*

Foundation

SDSM&T Foundation

306 East Saint Joseph St., Ste 200, Rapid City, SD 57701
Phone: 605.394.2436 / 800.211.7591 | Fax: 605.394.6679
foundation@sdsmt.edu