At Gooseneck, we’re committed to the communities we serve in North Dakota and northern South Dakota. To help make our donation process the most efficient, we have chosen to accept all donation requests through this online form.

How to Apply:
Please complete the form below to request a donation. All required fields (marked in green) on the form must be completed in order to successfully submit your request.
Once your request has been received you will be contacted by our Gooseneck Implement Marketing Coordinator to confirm your request and gather any further information.
 

Name of Organization:
Name of Event:
Date of Event:	Calendar
First Name:
Last Name:
Contact Phone:	( ) - Second three digits Last four digits
Contact Email:
Address:
City:
State:	AL AK AZ AR CA CO CT FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY
Zip Code:
Comment:
Attachment:
Please select checkbox: