Giveaway Item Donation

Event Details

April 13, 2024
12:00 PM
Carterville Community Center

Fields marked * require an entry.

GIVEAWAY ITEM DONATION

Memorial Hospital of Carbondale Skilled Care Nursey Reunion lunch will be hosting giveaways throughout the event. If you are interested in donating an item(s), please fill out the information below and a staff member will be in contact with you to arrange a pick-up of your donation.

Thank you for your generous donation and support of the event.

Item Information

Item Name:*

Estimated Value $:*

Item Description:*

Notes:

I am a(n):*

Individual Donor

Business Donor

I would like to remain anonymous:*

Yes

Contact Information

Company:*

First Name:*

Middle Name:

Last Name:*

Address:*

Address2:

City:*

State:*

Postal Code:*

Country:*

Mobile Phone:

Home Phone:

Work Phone:

Email:*

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