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Item Donations

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

Item Description Specifications

Specific date of event or a mutually agreed upon date:

Black out periods:

Expiration date:

Maximum number of attendees:

Any additional conditions, requirements or limitations:

Delivered to the Priory?

Yes

No

Contact Information

Company:*

First Name:*

Middle Name:

Last Name:*

At least one phone number is required.*

Mobile Phone:

Home Phone:

Email:*