KIN ON COMMUNITY HEALTH CARE 4416 S. BRANDON ST., SEATTLE, WA 98118
KIN ON HEALTH CARE CENTER PHONE: (206) 721-3630
FAX: (206) 721-3626
EMAIL: contact@kinon.org
SPECIAL EVENTS DONATION FORM
DONOR INFORMATION
Donor/Business Name_____________________________________________________
Address _________________________________________________________________
Phone _____________________ Email _______________________________________
Individual Authorizing Donation _____________________________________________
Phone _____________________ Email__________________________________
Contact Person for Arrangements____________________________________________
Phone _____________________ Email _________________________________
Event Invitation Requested Yes ______ No ______
ITEM DESCRIPTION
Please include pertinent details such as size, color, material, time restriction, valid for number of people, deadlines, restrictions, etc. to adequately describe item for the auction catalog listing.
Donor Stated or Retail Value $__________________
Donor Name for catalog ___________________________________________________
Donated Item(s): Date for delivery by donor ___________________
Date for pick up by auction staff ______________
AUTHORIZATIONS
Donor Signature _____________________________________ Date ________________
Solicitor ___________________________________________ Phone _______________
Kin On Community Health Care (EIN 91-1286273) & Kin On Health Care Center (EIN 91-1620786) are non-profit organizations under IRS Section 501(c)(3). Your donation is tax-deductible.