September 10, 2011

Donation Form

Contact Name for Donor: ______________________________________________________

Name as it should appear in print: _______________________________________________

Company Name: ______________________________________________________________

Address ______________________________________________________________________

Phone: ___________________ Fax: _____________________E-Mail: ___________________

Detailed Description of Item Donated: ________________________________________________________________________

Special Instructions or Restrictions: ________________________________________________________________________

Fair Market Value: _____________________________________________________________

Item included:________ Donor will deliver:________ Other: _________________________

Wine Donations (Please complete all applicable fields below)

Winery _______________________________ Varietal _________________

Name of Wine _________________________ Vineyard ______________________________

Vintage ________________________________ Bottle Size ____________________________

I prefer my donation be used for:

__________ Auction Lot __________Pouring __________Raffle __________No Preference

Donation Rep:

Rep Phone#:

Item Location:

Table #:

Browns Valley Family Club is a 501(c) (3) organization.  Donations are tax deductible as allowed by law.

Non-Profit ID #23-7133974

Browns Valley Elementary School

1001 Buhman Ave., Napa, CA  94558

Phone/Fax: 707-226-1866

Email: bvchilicookoff@yahoo.com

Website: www.NapaChiliCookoff.com