2022 Bourbon Mixer Auction Donation Form
Sign in to Google to save your progress. Learn more
Email *
Company / Donor Name *
DONOR TYPE (for recognition) Distillery *
Required
Detailed item(s) description (as will appear on auction website). Consider creating unique experiences or brand-specific gift baskets. As always, the distillery that raises the most money will be eligible for the coveted Bourbon Mixer Top Fundraiser award!
Specific Instructions/Restrictions (ie limited dates for availability, etc)
$$ Value of Donation
Contact First and Last Name *
Street Address *
City, State ZIP *
Mobile Phone Number (area code + phone)
Date Donation Available
MM
/
DD
/
YYYY
Pick up OR Delivery of Donation by July 22, 2022
Clear selection
If questions, contact katie@whiskychicks.com, 502-533-3894.
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Coalition For The Homeless. Report Abuse