Item Donation

Fields marked * require an entry.

Your donation to our organization is very appreciated. Please fill out this form by October 15th, and contact PAVE to arrange pick-up times.

Item Information

Item Name:*

I would like to donate anonymously:

Yes

This is a joint gift from myself and:

This donation is in honor of:

How did you hear about us?

I would like to be placed on your mailing list:

Yes

I would like to be placed on your email list:

Yes

Estimated Value $:*

Item Description:*

Notes:

I am a(n):*

Individual Donor

Business Donor

I would like to remain anonymous:*

Yes

No

Contact Information

Company:*

First Name:*

Middle Name:

Last Name:*

At least one phone number is required.*

Mobile Phone:

Home Phone:

Email:*