Silent Auction Item Donation Form printable pdf download

Silent Auction Item Donation Form

2017 SILENT AUCTION

DONATION FORM

DONOR INFORMATION

Company Name (as you want it listed) ________________________________________________________

_______________________________________________________________________________________

Contact _________________________________________ Contact Phone___________________________

(Please provide your complete address)

Address___________________________ City ___________________________ State _____Zip__________

E-Mail: ________________________________________ Website__________________________________

Telephone ________________________________ Fax: _____________________________

ITEM DEADLINE:

NLT Friday, January 13, 2017

For Office Use Only

Please send form with donation to:

Tangible Item Stored

United Way of Okaloosa & Walton Counties

Item Needs Pick-up

112 Tupelo Ave ~ Ft Walton Beach, FL 32548

___________

will pick-up

850.243.0315 ~ 850.243.6625 – fax

Certificate Received

Certificate Needed

Create Certificate

Donor should retain a copy for record/tax purposes

Added to Database

We are a 501(c)3 organization: FED ID 59-972293

Attention Donor: Your signature indicates that this information is complete & accurate.

Donor’s Signature

__________________________________________________

2017 Partner Sponsor

Thank you in advance for your generous donation!

“LOVE SHACK”

Silent Auction Item Donation Form