Wings for Mercy Ball

Mercy Care Foundation
Tel. (678) 843-8670 • Fax (678) 843-8679
Please Submit This Form At Least One Month Prior to the Event

Donor Contact Information

Donor Company Name
Contact First Name:*
Contact Last Name:*
Address 1:*
Address 2:
Zip Code:*
Email Address:*
Company Website:

Donor Name for Catalog

(List exactly as you wish to appear in Auction Catalog)

Donor Name for Catalog:*
Item Donated:*
Donor Stated Retail Value $*
Name of Individual for Thank You
(if Different than Donor/Contact Name)
Item Description*

(i.e. color, quantity, size, number of people, etc.) Please be complete as this will be used to write the auction catalog description.


Please state any limitations or special restrictions.
(If field is blank, MCF will assume there are no limitations or special restrictions.)

Expiration Date (if applicable):

Tangible Items

For Tangible Items:

Tangible Item will be delivered on (date)
Tangible Item Requested pick-up week

Intangible Items

(Donor: Please include any appropriate display materials)
Intangible Items

Will Provide Certificate Date:

Cash Donations

Cash Donations:


Gala Invitation List

Please add me to the gala invitation list:

To prevent spam, please tell us:
What is 3 + 8 ?

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