Fields marked * require an entry.

Thank you for your consideration of a donation! Our wish list includes:

Completed Themed Baskets
or the following items that we will be happy to basket!

Catholic Memorial spirit wear and items
Coach Purses
Vera Bradley items
Michael Kors items
Infinity scarves
Jewelry
Perfume
Hotel stays

Gift Cards:
Salons/Spas
Florists
Restaurants (Panera, Starbucks, Buffalo Wild Wings, etc...)
iTunes
Gas Cards (Kwik Trip is popular)
Target

Item Donation

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

I will drop off my donation in the CMH office prior to September 27, 2014.:*

Yes

No

Please contact me at the number below to arrange for pick up of my donation:

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:

Home Phone:

Work Phone:

Email:*