Request a Donation Form

Organization Name

Executive Director Name

We agree to recognize the donation as being from the Hagen History Center:

Yes

Contact Name

Phone Number

Email Address

Mailing Address

City

State

ZIP Code

Event Name

Event Date

My Company/Organization is located within 80 miles from the Hagen History Center.:

Yes

How will this donation be used?

What will the proceeds from your fundraising efforts support?

Brief Event Description:

Please attach a flyer for your event if applicable:

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356 West 6th Street
Erie, PA 16507

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Tuesday: 10 am - 5 pm
Wednesday: 10 am - 5 pm
Thursday: 10 am - 5 pm
Friday: 10 am - 5 pm
Saturday: 10 am - 5 pm
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