Mosaic Inspired Fundraiser Raffle Donation Form
Thank you for supporting our mission!
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Please describe what item/s you will donate:
In-Kind Value:
Date your donation will be ready for pick-up:
Upload the logo you would like to be used for marketing. (jpg. or svg. file prefered)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
THANK YOU FOR SUPPORTING OUR MISSION!
*If you did not upload the logo to this form, please send your business logo to cdrinville@mosaic-connect.org to be included in marketing materials for the event!
Submit
Should be Empty: