Use the form below to have your Appearance Request sent electronically.

Contact Information

All fields marked with a * are required.

* Organization Name :
* Address :
* City :
* State :	Please Select... AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
* ZIP :
* Phone Number : Area Code Required (ex. 123-456-7890)
Fax Number : Area Code Required (ex. 123-456-7890)
* Contact First Name :
* Contact Last Name :
* Contact Phone : Area Code Required (ex. 123-456-7890)
Contact Email Address :
Tax Exempt # / 503c

Event Information

All fields marked with a * are required.

* Event Name :
* Event Date: (MMDDYYYY)
* Event Location:
* Event Description:
Items To Be Used For:	Door Prize Live Auction Raffle Incentive Silent Auction Other (please describe)

Confirmation

I herby certify that a) the information provided in this request and the supporting documents are correct to the best of my knowledge and b) that the Internal Revenue Service 501(c)3 determination has not been modified, revoked, cancelled, or allowed to expire and c) donations will be used for the project/purpose outlined in the application and agreed to by both parties, and d) I agree to the appearance guidelines specified.

* Initial :
* Date: (MMDDYYYY)

Validation

The odd looking picture below is an extra security measure used to eliminate fraudsters from randomly filling out this form. Please enter the letters in the form below. Characters are not case-sensitive.



Enter the code above.

Please keep in mind that submitting an online request does not guarantee your organization will receive an appearance. We make every effort to accommodate as many requests as possible. However, due to the number of requests Rush receives on a monthly basis, we are simply unable to accommodate all requests that fit our guidelines. No phone calls please. All requests will receive either a letter of regret/refusal or a letter of acceptance.

Use of the Rapid City Rush logos or trademarks and/or any advertising that implies sponsorship, partnership or support by Rapid City Rush or the Central Hockey League must be approved in writing by Rapid City Rush. These policies are subject to change without notice.

Download the form below and mail it to:
Rapid City Rush
Rushmore Plaza Civic Center
444 Mount Rushmore Rd.
Rapid City, SD 57701
or fax: 605-716-6100

Download the Donation Request Form HERE.
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