New Page Title

Fields marked * require an entry.

Item Donation Form

Boise Blaze Birthday Bash Fundraiser

TAX ID: 26-0244283

Please mail donations to:

Northwest Association for Blind Athletes
PO Box 65265
Vancouver, WA 98665

Phone: 360.448.7254 | Fax: 1-800-880-9837 | Email: sgibbins@nwaba.org | website: www.nwaba.org

Donor Name (how listed in program):*

Contact Person:*

Contact Phone:*

Address (including city, state, zip):*

Item Description: (Please be as specific as possible):*

Restrictions & Expiration Dates:

Suggested Retail Value:*

Do you want us to make your gift certificate?

Yes

No

How we will receive your donation:*

I will mail the Item or Certificate

I will deliver the Item or Certificate

I would like the Certificate or Item picked-up, please contact me

I am interested in additional sponsorship opportunities:

Yes

No

I am interested in attending or purchasing a table at this year’s Benefit Dinner & Auction. Please send me an invitation.:

Yes

No

Contact Information

Company:

First Name:*

Middle Name:

Last Name:*

Address:

Address2:

City:

State:

Postal Code:

Country / Location:

Mobile Phone:

Home Phone:

Email:

About Us

ENRICHING LIVES. PROVIDING OPPORTUNITIES.

Follow Us