Fields marked * require an entry.

Procurement Form

Thank you for donating an item or package to the Stronger Families 2021 Hope for Heroes Gala & Auction. Fill out the form below completely. We will be in touch with you if we need additional information.

All items and forms must be received by October 1, 2021

Procurement Form

Item Information

Item Name:*

Estimated Value $:*

Item Description:*

Notes:

I am a(n):*

Individual Donor

Business Donor

I would like to remain anonymous:*

Yes

No

Restrictions and Expiration Date?*

Please check one of these boxes:*

Donor to mail gift certificate or item to Stronger Families

Stronger Families has permission to create a gift certificate for this item

Donor would like Stronger Families to pick up gift certificate or item

Donor Name (if different than person filling out this form):

Contact Information

Company:*

First Name:*

Middle Name:

Last Name:*

Address:*

Address2:

City:*

State:*

Postal Code:*

Country / Location:*

At least one phone number is required.*

Mobile Phone:

Work Phone:

Email:*