SILENT AUCTION DONATION FORM PLEASE RETURN THIS FORM NO LATER THAN THURSDAY, MARCH 15TH 2013 Email or FAX this form to: Shannon Wright shannon@allyourfavouritethings.com Fax: 416- 972-0351 Silent Auction items listed below must be delivered by: Thursday March 22th 2013 Delivered to: 1 St Clair East, Suite #1001, Toronto, Ontario. M4T 2V7 NAME: BUSINESS NAME: NAME OF DONATED ITEM: DESCRIPTION OF ITEM: YEAR OF PRODUCTION: (appropriate for antiques, wine, whiskey, etc.) WHOLESALE PRICE : $ RETAIL PRICE: $ OTHER DETAILS: (include references to autographs, previous owners, etc.) Thank you for your Donation! 87 Pembroke Street, Toronto, Ontario M5A 2N9 | TEL: 416.967.6060 | FAX: 416.924.6900 | www.streethaven.com CHARITABLE REGISTRATION: 12953-5175-RR0001