Shatterin` Clay General Donation Form

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Friday, October 30, 2015 • Hunter’s Run Gun Club
1365 Northwest Drive, Port Allen. LA 70767
DONATION FORM
Please PRINT and completely fill out this form so we can give you accurate and proper recognition.
Please email this form to [email protected] or mail to P.O. Box 85223, Baton Rouge, LA 70884
Company Name (to appear in print & online): _____________________________________________
Mailing Address: _____________________________________________________________________
Phone Number: ___________________________ Fax Number: _______________________________
Email: ______________________________________________________________________________
Website: ____________________________________________________________________________
Contact Name & Position: _______________________________________________________________
Signature: ___________________________________________________________________________
Item(s) Donated: ______________________________________________________________________
Retail Value: $ ____________________
Wholesale Value: $ ______________________
Description: __________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Gaitway is a 501(c) 3 non-profit organization offering services in Equine Assisted Activities and Therapies to
individuals with special needs in Baton Rouge and its surrounding areas.
THANK YOU!
For Office Use Only: DP_______
Donation Letter___________
Payment received____________
Initials_______
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