Skip to content
Accessibility info
Bailey Place Insurance on Facebook
|
Bailey Place Insurance on LinkedIn
|
Bailey Place Insurance on YouTube
|
Bailey Place Insurance on Instagram
|
Bailey Place Insurance on Yelp
|
Bailey Place Insurance on Google
info [at] baileyplace [dot] com
Client Portal
607-756-2805
2 N. Main Street
Cortland, NY 13045
607-844-8626
78 North Street
Dryden, NY 13053
607-319-0094
2428 N. Triphammer Rd
Ithaca, NY 14850
Free Insurance Quotes
INSURANCE
CLAIMS & SERVICE
NEWS & UPDATES
ABOUT
CONTACT
Charitable Donation Request
from Bailey Place Insurance
Contact Information
Your Name
✶
Title
Email
✶
Phone
Organization Information
Name of Organization
✶
Website
Street Address
✶
City
✶
State
✶
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington, DC
Other
ZIP
✶
Type of Organization
✶
For-Profit
Non-Profit
Has this organization received a donation from Bailey Place in the past?
Yes
No
Is your organization a customer of Bailey Place Insurance?
Yes
No
Do you know someone that works at Bailey Place Insurance?
Yes
No
Name(s) of Employee(s)
Donation / Event Information
Total Budget/Fundraising Goal
Date of Event or Donation
✶
Requested donation
Type of Donation Requested
Monetary
Merchandise
How will the donation be utilized/benefit the community?
✶
Will Bailey Place be recognized for our support? If so, how?
Additional Information
Subject
Please leave this field blank. This field is here to help us protect against automated submissions. If you put something into this field, your entire submission will be ignored.
Submit
Secure form
We respect your privacy. Your info will be sent securely and handled with care.
View privacy policy
.
Live Chat