Peachstate PCA Burgers and Bids Auction Donation

Is an individual or a company making this donation?

First Name:

Last Name:

Donor Contact Email:

Donor Address (For Tax Purposes)

Street Adress

Street Address 2

City

State

Postal/ Zip Code

Company Name:

Company Address (For Tax Purposes)

Street Adress

Street Address 2

City

State

Postal/ Zip Code

Primary Contact Name:

Primary Contact Email:

Donated Item

Name of donated item or experience:

Item or Experience Description:

Item Category

Fair Market Value of donation (what does this sell for is someone were to purchase this):

How would you like for the winner to redeem?

Gift certificate or voucher attachedPlease connect me to the winner by emailPlease have someone from PCA contact me to help coordinate with the winner

If this is a dining experience or other service related donation, is gratuity included in the donation?

N/A - this is not for a serviceGratuity is NOT included and the winner is responsibleGratuity is included as part of the donation

Are there any restrictions or blackout dates

YesNo

Please list the restrictions or blackout dates:

Please upload gift certificate or voucher here.

Please upload your logo

Please attach any images of the item/experience to help promote

Please attach additional images of the item/experience to help promote

Contact Information