MOVERS & SHAKERS
SILENT AUCTION DONATION FORM
The Heart of Illinois Chapter of SGMP is holding their
annual MOVERS & SHAKERS fundraiser
MONDAY, APRIL 18, 2011 from 5:00PM to 8:00PM at Bennigan’s!
Proceeds go to our scholarship fund. We need your help to be successful! Please
support the chapter by donating silent auction items and attending the event!
I would like to donate _______________________________________________ for the silent
auction or raffle.
Please provide a detailed description of your item:
We are also doing the WALL OF WINE again this year! Donate a bottle of wine with a minimum value of
$10. If every member donates ONE bottle of wine, we’ll have almost 90 bottles to pull from!
If you are providing a gift certificate, please provide the following on the certificate:
-Name of product or service
-Description of what is included and what is excluded
-Name of person to contact for further information
-Name, address and full contact information for you or your company
-Instructions on how to redeem item
-Include any additional information such as a photo or description brochure as appropriate
-Date of expiration
_______ I will bring the item to Movers & Shakers on April 18th.
_______ I will ship/mail the item.
Please mail or fax this form and items to: Angie Wanger
Illinois Public Health Association
223 S. 3rd Street
Springfield, IL 62701
Fax: 217-522-5689 Email: email@example.com