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2022 Change for Charley Auction Donor Form
Thank you for contributing to the 3rd annual Change for Charley benefiting EB Research Partnership! The event will be held on Saturday, March 9th in Chicago, IL. Our team will contact you with details on shipping and delivery of physical items. If you have any questions, please contact
info@ebresearch.org
.
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Email
*
Your email
Company/Donor Name
*
Your answer
Donor First Name
*
Your answer
Donor Last Name
*
Your answer
Address Line
*
Your answer
City
*
Your answer
State
*
Your answer
Zip
*
Your answer
Phone Number
*
Your answer
Solicitor First Name
Your answer
Solicitor Last Name
Your answer
Solicitor Email Address
Your answer
Solicitor Phone Number
Your answer
Auction Item or Experience
*
Your answer
Estimated Value of Auction Item
*
Your answer
Description of Item
*
as it should appear in all event materials
Your answer
Presentation of Item
*
Example: gift certificate, physical item, poster display, etc.
Your answer
Do you need us to make a gift certificate for you?
*
Example: gift certificate, physical item, poster display, etc.
Yes
No
Please list ALL restrictions, blackout dates, expiration dates or limitations:
*
If this does not apply to the donated item, please write "None"
Your answer
A copy of your responses will be emailed to the address you provided.
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