Black & Blue Ball Donation Form
Donor first and last name OR organization
Contact Name if different from above
Please enter a valid phone number.
Street Address Line 2
State / Province
Postal / Zip Code
Description of Donated Item(s) and include value ($) Also, please include (if applicable) description of bottles of wine or liquor you are able to contribute to the bottle pull.
Please Check One Below. Donated items due no later than Friday, April 12th, 2024
Please Check Below
Will deliver donated item to NOHF office at 17407 Lorain Ave. Ste #206 Cleveland, OH 44111. Email Kathy Cole at email@example.com to set up time for drop off.
Will deliver to Kathy Cole home address at 8885 Tanglewood Trail Chagrin Falls, OH 44023. Email Kathy Cole at firstname.lastname@example.org to set up time for drop off.
Contact me to pick up donated item(s)
I want to donate to the bottle pull. Deadline to turn in bottles is Thursday, April 18th at The Aviator no later than 6:00pm -OR- include with silent auction donation.
( X )
The Black & Blue Committee will purchase and put together a basket for you.
Debit or Credit Card
Credit Card Number
Please click one of the PayPal options to complete payment and
Should be Empty: