2016 Auction Donations

Fields marked * require an entry.

Thank you so much for your generous donation to the 2016 Go for the Gold Dinner & Auction!

Donation Form

P O Box 65265 Vancouver, WA 98665
p: 1-360-448-7254 f: 1-800-880-9837
e: bhenry@nwaba.org w: www.nwaba.org Tax ID: 26-0244283

Thank you for supporting Northwest Association for Blind Athletes!

Item Information

Item Name:*

Estimated Value $:*

Item Description:*

Notes:

I am a(n):*

Individual Donor

Business Donor

I would like to remain anonymous:*

Yes

No

Would you like NWABA to create a gift certificate for this item?*

Yes

No

Does this item have any restrictions or expiration?*

Contact Information

Company:*

First Name:*

Middle Name:

Last Name:*

Address:*

Address2:

City:*

State:*

Postal Code:*

Country / Location:*

At least one phone number is required.*

Mobile Phone:

Home Phone:

Work Phone:

Email:*

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