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We understand that being a responsible member of our community means giving
back — and that the communities we work in are a huge part of the reason we thrive.
Because of that, we are dedicated to supporting and helping to strengthen our
communities by supporting local organizations.

We try to respond to as many requests as possible. To help this process along, we ask
for a little information about your organization and your request.

     
Organization:   Name Of Event:
 
Event Date:   Contact Name:

 
 
Address:  
   
City:
 
State Zip
 
 
Phone:   Fax:
 
Email:    
   
 
Non Profit Status:    
   
   
Purpose Of Event:    
     
Type Of Donation Requested:  
Advertisement Gift Certificate Cash Contribution
Other    
If Other, Please Describe  
 
   
Amount Requested:   Deadline:
 
     

 
   
     
 
Harvey and Lewis Opticians | 45 Aslyum Street Hartford, CT 06103 |Tel 860-522-2020 | Fax 860-522-5277 | info@harveyandlewis.com
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