In order to be considered and help us expedite the donation procedure, please complete this form in its entirety (all fields are required). Requests should be made at least two weeks prior to the event date.
Name of Organization *
Organization City *
Organization State *
Contact Person (First Name) *
Contact Person (Last Name) *
Phone Number *
Contact Email *
Are you a Charitable Organization? * Yes No
Date of Event ( 00/00/0000) *
Name of Event *
What type of event will you be hosting? (Silent or live auction, raffle, etc.) *
What kind of attendance do you anticipate for your event? *
Who will these proceeds benefit? *
Additional Comments (optional)
Please include a wish list of your top 3 requests for donation. (Cash, trade, product, other) *
For security reasons, please type what you see
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