2024 Chicago Select Auction Donor Information

Donor Information:
Corporation (as listed on all print)
Contact Name (as listed on all print)*
Title
Email*
example@example.com
Address*

Address

Street Address Line 2

City, State, ZipState / Province

Postal / Zip Code
Work Phone
Cell Phone
If the winner of the auction item should contact someone other than the donor, please list his/her contact information below.
Contact Name
Phone Number
Email
example@example.com
Value of Donation*
Donation Description (Please fill out one form per item)*
Required Golf Course Donation Information. (If this is a golf course donation, please check all that apply, if this is not a golf course donation please select "not a golf course donation, other item"):
Hosted ThreesomeUnhosted FoursomeLunch will be includedCart will be includedCaddie will be includedNot a golf course donation, other itemOther
Golf Course Name
Golf Course Location (City & State)
Restriction- Applies to ALL donations (Expiration dates, blackout dates, etc. If there are no restrictions to this item, please put N/A)*
Please Check all that apply*

This is a corporation donationThis is a personal donationI wish to remain anonymousI will provide a certificate for this donation
Please note: Items that must be redeemed by a certain date (i.e. tickets for sporting events, concerts, etc.) cannot be within 30 days of the event date. If an expiration date is not provided, a default expiration date of one year after the event date will be assigned. All items donated will be used in auctions benefiting the American Cancer Society.
Signature*

Clear
Should be Empty: