2016 In-Kind Donation Form

April 2, 2016 Renaissance Dallas Benefiting Research for Multiple Sclerosis

Donor:
(Please list your name as you would like to appear in printed materials)

Contact Name:

Phone:

Address:
City:

State:

Zip:

Email:
Description of Donation:

Restrictions (if applicable):

Market Value:

Expiration Date (if applicable):

Signature:
Does a gift certificate need to be printed by the Yellow Rose Gala?

Yes

No

DELIVERY INSTRUCTIONS:
Item delivered with contract
Item to be delivered (Date):
Item to be picked up (Date):
Yellow Rose Gala Foundation EIN: 47-1982785
Please email contract to donate@theyellowrose.org or mail to:
YELLOW ROSE GALA FOUNDATION PO BOX 192131 DALLAS, TEXAS, 75219, USA

For more information, contact Fallon Way at 512-842-ROSE or visit theyellowrose.org