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Charitable Contributions Request Info Request Info   Tell a Friend Tell a Friend   Printable Version Printable Version
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Application Form (PDF 188)
Application Procedures


Application Procedures

If your organization has a program that falls within the AmerisourceBergen Charitable Contributions Committee’s guidelines, you are invited to submit a contribution request. Your application must include the following:

  • A brief description of the organization including its legal name, activities, history and purpose.


  • Budget information, including annual report or financial statement that lists the organization’s sources of financial support.


  • A copy of the current 501(c)(3) nonprofit, tax-exempt Internal Revenue Service determination letter.


  • A list of names and business or professional affiliations of the organization’s officers and directors.
  • A statement of the proposed project, which addresses:
    o The purpose of the project.
    o Its short-term and long-term goals.
    o How the request supports the ABC Charitable Contributions Mission.
    o The estimated time required for project completion.
    o Information on how the project will be evaluated and measured.
  • A list of AmerisourceBergen associates and directors who currently volunteer with your organization or serve on the Board of your organization.


  • A description of how the AmerisourceBergen’s Charitable Contributions Committee’s support will be recognized.
Funding decisions are made on a quarterly basis by the AmerisourceBergen Charitable Contributions Committee; please allow up to ninety days for a response to your request. Send your request to:
AmerisourceBergen Charitable Contributions Committee
Attn: Kathy Katona
AmerisourceBergen Corporation
1300 Morris Drive
Chesterbrook, PA 19087
For an Application Form, click here (PDF 188KB).