MW Quad Cities Go Red for Women Auction Donor Agreement Form

American Heart Association Auction Donor Agreement Form

Quad Cities Go Red for Women
Please provide me with information for attending or sponsoring the Quad Cities Go Red for Women Luncheon.*
I would like to volunteer. Please contact me.*

I would like to volunteer day-of the event.I would like to join the event leadership team.I do not wish to volunteer.
Donor Information

(If there are multiple donors, please include names of all donors you would like listed in the program.)
Donor Name(s)*
Contact*

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
I wish to remain anonymous. Please do not list our business in the event program.*
Item Information
Detailed Item(s)/Service Description.*
We reserve the right to package items.
Donor's Estimated Value of Item ($)*
(The IRS requires AHA to provide to the buyer.)
Restrictions/Expiration of Item/Service*
Please date gift certificates the event date and allow a minimum of six months to redeem, one year preferred.
If Donation is a gift certificate:*

Gift certificate enclosedPlease have AHA prepare gift certificate
Delivery Information:*

Please have AHA volunteer pick-up itemDonor to deliver to AHA officeItem accompanies donation form
Does item have display material?*

YesNo
Does the material need to be returned?

YesNo
Donor did not receive goods or services. No goods or services were provided in consideration of this gift.
Should be Empty:

American Heart Association Auction Donor Agreement Form

Donor Information

Item Information