Item/service donated: _______________________________________ Retail value: _______
Description: (size, quantity, color, available dates, restrictions, expirations, etc.)
_________________________________________________________________________
_________________________________________________________________________
__________________________________________________________________________
Donor Company/Organization’s name as it will appear in the program:
__________________________________________________________________________
Donor Contact Name:
__________________________________________________________________________
Address: _______________________________________________________________
City: _______________________ State: _____ Zip: _________
Phone: ____________________ Fax: _____________________
Can the item by exchanged? ( ) Yes ( ) No
Donor will deliver on: __________________________________________
Thank you for your donation!
The 2010 Gala Planning Committe