KcATC Auction/ Raffle Donation Form

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Email *

Donation Title:

Donation Description:

Donation Link:

(Note: If you have an online link to the item, include it here!)

Donor Name:

(Note: List the individual(s) who should get credit for the donation.)

Value of Donation:

Donor Mailing Address:

Donor City, State, Zip:

Donor Email:

Donor Phone:

List any restrictions that should be noted on your donation, such as expiration dates, black-out dates, exchange or transfer policies, etc.

Is there a certificate associated with this item? *

Yes

Would you like a certificate?

If there is not a certificate associated with this item, please check this box if you'd like Kansas City Autism Training Center to make a certificate for you. The certificate will use the name(s) provided in the donor field above.

Please send me a certificate

Donation Source:

Business

KcATC Family

Non-KcATC Family

Grandparent or Loved One

KcATC Alumni

Other:

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A copy of your responses will be emailed to the address you provided.

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