Donation is for (select one): Silent Auction
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Live Auction
Other

Name of Business or Individual:

Address of Business:

City:

State:

Zip:

Phone:

Contact Person:

Title:

Email:

Business Owner’s Name (if different from Contact):

Primary Mailing Address:

Description of Donated Item:

Retail Value (as determined by donor):

Restrictions of use: no change given from gift certificates; no cash exchanges for prizes. Donor m

Name Donor Wishes to Use for Recognition:

Does donor wish to be anonymous?

Date donation is to be picked up by solicitor:

Is this a new donor to Colleyville Woman’s Club?

Colleyville Woman’s Club Solicitor:

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