2015 Spring Tribute Gift Donation Registry – Online Auction
DETAILED DESCRIPTION OF ITEM OR SERVICE BEING DONATED
Be specific, this information will be used to promote & describe the item in the online auction website.
Item:
___________________________________________________________________________________________________
Value: ___________Size: ________________________ Color: ___________________ Expiration Date: __________
Restrictions:
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Additional Description:
______________________________________________________________________________________________________
______________________________________________________________________________________________________
NAME & PHONE NUMBER OF BRAIN INJURY ASSOCIATION OF MICHIGAN REPRESENTATIVE GENERATING GIFT
(if applicable)
Name: _____________________________________________________ Phone Number: ___________________________
COMPLETE INFORMATION OF PERSON OR CORPORATION MAKING THE DONATION
Please be exact - the donor’s name will appear in printed materials and on the Auction Website
Donor Name: __________________________________________________ Phone Number: _________________________
Address:
___________________________________________________________________________________________________
____________________________________________________________________________________________________
Email: ____________________________________________________
Contact Person: _________________________________ Phone Number: _____________________________________
(if different than above)
____ The donated item will be mailed or delivered to Brain Injury Association of Michigan.
____ The donated item will need to be picked up.
Mail, Fax, or Email this form to Jenna Huskinson at:
Brain Injury Association of Michigan
Fax: (810) 229-8947
7305 Grand River, Suite 100
OR
Email: jhuskinson@biami.org
Brighton, Michigan 48114-7379
Call BIAMI at (810) 229-5880
Items should be delivered before the opening of the auction on Monday, March 30.
In order to be listed as a donor in the Ad Journal Program, registry information must be received by Monday, March 30.
Our Online Auction can be viewed at: biddingforgood.com/biami