In-Kind Donation Form - Active Minds

In-Kind Donation Form

Please complete and return this form by September 10, 2021 (for inclusion in event materials, all sponsor logos, collateral, and other creative assets must also be received by that date). Alternatively, please visit activeminds.org/casino-night-DC to confirm your sponsorship online. Active Minds, Inc. is a 501(c)3 organization, Tax ID# 20-0587172.

Donor First Name

Donor Last name

Title

Contact First Name

Contact Last name

Title

(If different from donor)

Street Address

City

State

Zip

Phone

Organization/Company

Company Logo

Item 1 Description

Value

Item 1 Image

Item 1 Restrictions (e.g. expiration date, blackout Dates, min/max guess etc.

Item 2 Description

Value

Item 2 Image

Item 2 Restrictions (e.g. expiration date, blackout Dates, min/max guess etc.

Please send items to be auctioned to:
Andrea Sturgis, 1801 Battlement Ct, Severn, MD 21144
Memo: Active Minds DC Casino Night

Contact Information