Instructions for completing this form:

1. Please note that all sections must be completed in order to provide you with a receipt for your taxes.

2. A confirmation of this form will be sent to you. Please keep it for your records.

3. Deadline is April 1, 2015.

Name *
Name
Address
Address
Phone *
Phone
Donated Item Information
$
Item Delivery/Pick-up
Items can be delivered to the following address prior to the event: 312 Church St. SE, Suite 4-105 Nils Hasselmo Hall, Minneapolis 55455. Please indicate below if you will be delivering your item or if you wish to have it picked up.
Select One *