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Text Box: THE PEMBROKE CHARITY, INC. P.O. BOX 708 PEMBROKE, VA 24136   IS YOUR ORGANIZATION TAX EXEMPT? _____ YES _____ NO IS YOUR ORGANIZATION NON-PROFIT? _____ YES _____ NO PLEASE GIVE A DETAILED DESCRIPTION OF THE NATURE OF YOUR REQUEST AND A COST FOR THE ITEM(S) REQUESTED: AN ORGANIZATIONAL FINANCIAL STATEMENT MUST BE INCLUDED WITH THIS REQUEST. ONLY REQUESTS THAT MEET NON-PROFIT / TAX EXEPMT STATUS WILL BE REVIEWED.  SIGNED: ______________________________________________ DATE: ________________