Spring Fling Item Donation

Fields marked * require an entry.

Please e-mail your logo image to annstrauserpalmer@gmail.com

Item Information

Item Name:*

Estimated Value $:*

Company Name (as you prefer to be listed):*

Item Description:*

Notes:

I am a(n):*

Individual Donor

Business Donor

I would like to remain anonymous:*

Yes

No

Are there special terms or restrictions, including expiration date?*

Yes

No

Special Terms/Restrictions Detail (expiration date if applicable):*

Donation Item Delivery Method:*

If You Need Someone to Pick-up Your Item, please advise the date for pick-up.:

My Bryker Woods contact person is:*

Contact Information

Company:*

First Name:*

Middle Name:

Last Name:*

Mobile Phone:

Email:*