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Thank you for your interest in donating to the Wheels & Heels Gala. Upon completing the form below, you will receive an email receipt. A member of our staff will reach out to you. We appreciate your support!

If you have multiple donations, please fill out the form for each donation if they are not part of the same package.

America's Automotive Trust EIN #81-4337717

Procurement Donation Form

Item Information

Item Name:*

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Estimated Value $:*

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Item Description:*

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Notes:

I am a(n):*

Individual Donor

Business Donor

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I would like to remain anonymous:*

Yes

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Donation will be delivered?*

Yes

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Please make arrangements to pick up the donation?*

Yes

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Is there a gift certificate?*

Yes

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If you are the solicitor for the donation, please fill out your name:

Donor Agreement

By filling in my name, I agree this will be the electronic representation of my signature, and I verify I am responsible for this donation:*

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Contact Information

Company:*

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First Name:*

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Middle Name:

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Last Name:*

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Address:*

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Address2:

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City:*

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State:*

Province State is required for the United States

Postal Code:*

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Country / Location:*

Country is Required

Mobile Phone:

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Email:*

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Procurement Donation Form

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Procurement Donation Form

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