To apply for Bridgestone Support, please complete the following form

*Required fields
Thank you for your submission.
We're unable to process your application at this time. Please try again later.
aoda
This is a required field.

Our organization is:*


Who may we contact about this application?

This is a required field.
This has exceeded the limit of 100 characters.

First Name*

This is a required field.
This has exceeded the limit of 100 characters.

Last Name*

This is a required field.
This email format is invalid!
This has exceeded the limit of 100 characters.

Contact's Email Address*

We will not share, exchange, or sell your email
This is a required field.
This phone format is invalid.
This has exceeded the limit of 100 characters.

Phone*

Organization Information

This is a required field.
This has exceeded the limit of 100 characters.

Organization Name*

This is a required field.

Country*

This is a required field.
This has exceeded the limit of 100 characters.

Street Address*

This has exceeded the limit of 100 characters.

Apt./Suite

This is a required field.
This has exceeded the limit of 100 characters.

City*

This is a required field.
This zip code format is invalid.
This has exceeded the limit of 100 characters.

ZIP Code*

This is a required field.

We consider contributions to a variety of causes and organizations. Categories we consider regularly are listed below. Please select the one that most applies to your organization or program.*

Education

Welfare of Children

Environment and Conservation

Other

Tell us about your organization

This is a required field.
This has exceeded the limit of 5000 characters.

What are some of the key accomplishments of your organization?*

Characters Remaining:
This is a required field.
This has exceeded the limit of 5000 characters.

What are the key objectives of your program?*

Characters Remaining:
This is a required field.
This has exceeded the limit of 5000 characters.

Who would benefit from your program?*

Characters Remaining:
This is a required field.
This has exceeded the limit of 5000 characters.

What method(s) would you use to evaluate the program's success?*

Characters Remaining:

Help us understand the level of contribution you're seeking

This is a required field.
This has exceeded the limit of 5000 characters.

What dollar amount are you seeking in relation to the total need?*

Characters Remaining:
This is a required field.
This has exceeded the limit of 5000 characters.

How would your organization use Trust Fund money? (Be as precise as possible)*

Characters Remaining:

Please share some information to help us evaluate need

This is a required field.
This has exceeded the limit of 100 characters.

Current year's operating budget, if available*

Tax-Exempt status

This is a required field.

Non-Discrimination

This is a required field.

Who are the members of your Board of Directors?

This is a required field.
This has exceeded the limit of 100 characters.

Member 1*

Name*
This is a required field.
This has exceeded the limit of 100 characters.

 

Title*
This has exceeded the limit of 100 characters.

Member 2

Name
This has exceeded the limit of 100 characters.

 

Title
This has exceeded the limit of 100 characters.

Member 3

Name
This has exceeded the limit of 100 characters.

 

Title
This has exceeded the limit of 100 characters.

Member

Name
This has exceeded the limit of 100 characters.

 

Title
This has exceeded the limit of 100 characters.

Member

Name
This has exceeded the limit of 100 characters.

 

Title

Please list other contributors and the amount of their donation

This is a required field.
This has exceeded the limit of 100 characters.

Contributor 1*

Name*
This is a required field.
This has exceeded the limit of 100 characters.

 

Amount of Donation*
This has exceeded the limit of 100 characters.

Contributor 2

Name
This has exceeded the limit of 100 characters.

 

Amount of Donation
This has exceeded the limit of 100 characters.

Contributor 3

Name
This has exceeded the limit of 100 characters.

 

Amount of Donation
This has exceeded the limit of 100 characters.

Contributor 4

Name
This has exceeded the limit of 100 characters.

 

Amount of Donation
This has exceeded the limit of 100 characters.

Contributor 5

Name
This has exceeded the limit of 100 characters.

 

Amount of Donation
This has exceeded the limit of 5000 characters.

If benefits are involved, please describe the breakdown of deductible vs. non-deductible portions

Characters Remaining:

Proposals meeting basic criteria requirements are held for review by the Bridgestone Americas Trust Fund committee, which meets several times throughout the year. Subsequent to the review, applicants will be notified of the committee's decision.

This site uses cookies to enhance your user experience. By continuing to browse our website, you agree to use these cookies. For more information on what cookies we use and how to manage these cookies please visit our Privacy policy
OK