Form Center

2. Department of Parks and Recreation

   Donation Request

   Please complete the information below. 

   Organization/Club must be Livonia based. 

   Event must benefit a Livonia based school or organization. 

4. Organization Name*
5. Email Address
7. Name of person submitting request*
9. Organization's Address*
11. City*
12. State*
13. Zip Code
15. Phone Number*
16. Brief Description of organization/club:*
18. Event Date*
19. Type of event?*
21. Anticipated number of participants:*
22. What will the proceeds be used for?*
24. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
25. Please check which type of donation you would like to receive, there is no guarantee. *

    1. Day Passes to Jack E. Kirksey Recreation Center
    2. Golf Passes to the City golf courses

    If approved, you will receive a phone call as to when it can be picked up. 

27. Electronic Signature
Leave This Blank:


29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit

* indicates a required field