Raffle/ Auction Donation Form

Raffle/ Auction/ Donation Form

Please complete donation form by the first day of the month (if applicable) of the event date in order to receive promotional benefits. For example if you’re donating to Noche de Oro, complete the form by October 1. Recognition in pre-event promotional email and recognition on social media/ website will begin as soon as we receive this form.
Donor Name*

PrefixFirst NameLast Name
Please fill the list below.*
Expiration Date (If Applicable)

MonthDayYear
Date
Contact Name*

First NameLast Name
Solicitor Name (person who requested donation)*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email Address*
example@example.com
Pickup Date

MonthDayYear
Date
Pickup Details*
Additional Notes/Special Instructions*
Please select one.*

I am enclosing a gift certificate.I will forward certificate at a later date.Please generate a certificate for me.Please contact me to pick-up item.I will deliver item to GSF office or event
Auction Mailing Address & Contact: 477 Spencer Lane San Antonio, TX 78201 210-670-6200| info@GabriellasSmile.org
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Raffle/ Auction/ Donation Form