Matching gift application

Please use this form only if your company's name is listed in bold on the list of companies that match employees' gifts to Minnesota Public Radio. Or, check with your company's business or personnel office for the proper form. You must be an MPR member to participate in this program; if you are not currently a member, sign up now with our online membership form.

To be completed by MPR member:
Date of gift:
Amount of gift:
Member name:
Address:
City:
State:
Zip code:
MPR member number:
Company:
Address:
City:
State:
Zip code:
Employee # (if applicable):
Daytime phone:
Member signature:
To be completed by Minnesota Public Radio:
A gift of was received on by Minnesota Public Radio.
Certifying officer:
Officer's signature:

MPR's Federal tax exempt number: 41-0953924

Print out and mail this completed form to:
Minnesota Public Radio, Member Services Team
480 Cedar Street
Saint Paul, MN 55101

If you have questions about MPR's Employer Matching Gift Program, please contact Nicole Greenly at 651-290-1560 or 800-652-9700; ngreenly@mpr.org.