LOYOLA SCHOOL - 20th ANNUAL BENEFIT AUCTION Kentucky Derby Business Name or First and Last Name of Individual Donor ____________________________________________ Contact Name for Business Listed Above __________________________________________________________ Circle any that apply: a) Alumnus b) Business/Vendor c) Current Parent d) Past Parent f) Trustee/Former Trustee
Address ____________________________________________________________________________________ City ____________________________________ State ____________________Zip Code __________________ Email ________________________________________________ Phone ________________________________ DONATION INFORMATION Description of Tangible Item/Service ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ Additional Information (if applicable, designate item restrictions/specific use, dates, etc.) ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ Fair Market Value of the Donation $ _____________________ (For tax-deductibility purposes)
PLEASE CHECK ONE □ Donor to mail/deliver item by: ____________________ (date) □ Gift certificate enclosed. □ No tangible gift certificate enclosed; Loyola should create one for the donor. All donated items become the sole property of Loyola School. All proceeds from the Auction benefit Loyola School.
Solicitor Information Solicitor Name ________________________________________________________ Phone _______________________________________ Circle any that apply: a) Alumnus b) Current Parent c) Past Parent d) Trustee/Former Trustee For Office Use Only □ Gift certificate received
□ Item received
□ Create certificate
□ Procurement # _____________
□ Date Entered/Initials _____________
Send your completed form with gift(s) to: Loyola School - Advancement Office - 980 Park Avenue, New York, NY 10028 Phone: 646.346.8135 - Email: kfiscus@loyola-nyc.org - Fax: 212.879.4864 DONATIONS MUST BE RECEIVED BY WEDNESDAY, APRIL 4, 2012 IN ORDER TO BE INCLUDED IN PRINT AND ONLINE MATERIALS.
On behalf of the 2012 Auction Committee, thank you for your generous participation!