ETRN Local Giving Request Form | Equitrans Midstream Corporation

Name of the organization *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Country *

Website / URL

Contact person *

First

Last

Phone *

Email *

501(c)3? *

Type of request *

Amount requested

Date of event (if applicable)

Date

Time

Volunteer opportunities available for event

Description of sponsorship or donation request *

Please include the organization’s current W9 form *

Click or drag a file to this area to upload.

Additional supporting documents

Click or drag a file to this area to upload.

Request submitted by Equitrans employee? *

If yes, employee name:

Volunteer opportunities for event (if applicable)

Local Giving/Sponsorship Request Form