Item Donation

Item Information

Item Name:*

Estimated Value $:*

Item Description:*

Expiration Date (if applicable):

Notes:

I am a(n):*

Individual Donor

Business Donor

Business Name (if applicable):

I would like to remain anonymous:*

Yes

No

This item is a:*

Physical Item

Non-physical Item: I will Provide the Gift Certificate

Non-physical Item: SIDRC will make the gift certificate.

Item Delivery/Pick Up:*

I would like Seattle-ID Rotary to contact me about picking up this item.

I can deliver to item’s winner (Seattle area). See receipt for further instructions

I will email Gift Certificate to Seattle-ID Rotary. See receipt for further instructions

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:*