MW 2024 Ann Arbor Heart Ball Auction Donation Form

2024 Ann Arbor Heart Ball Auction Donation Form

DEADLINE: September 6, 2024
Company/Name*
(How would you like the company/name listed in auction booklet?)
Contact Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number
Please enter a valid phone number.
Donation Information
Name of item(s)*
Detailed Item Description. (Please include size, color, dates, number of people, etc.)*
We reserve the right to package items.
Special Conditions/Restrictions*
Unless otherwise noted, this contract is valid for one year after the auction date.
Estimated Value of Item ($)*
(The IRS requires American Heart Association to provide to the buyer.)
Type of Donation:*

ItemGift Certificate
Aquisition Information:*

I will mail the item to the Association office (Attn: Olivia Marquez, 26555 Evergreen Rd, Suite 570, Southfield, MI 48076)Item unable to ship - available for pickup on the date/location provided below
Date

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Other Instructions:
Donor did not receive goods or services. No goods or services were provided in consideration of this gift.
Should be Empty:

2024 Ann Arbor Heart Ball Auction Donation Form