Business/Donor Name ______________________________________________________________________________________________________________________________________________________ (as you would like it to appear in gala-related printed materials)

If Company, Contact Name_____________________________________________________________________________________________________________________________________________________

Address:__________________________________________________________________________________________________________________________________________________________________________________________________________

City/State/ZIP:_________________________________________________________________________________________________________________________________________________________________________________________

Telephone: _______________________________________________ Email:_________________________________

Tangible Items:__Gift Certificate(s) with cash value (such as prepaid store cards or debit cards)__ Food and Beverages ___Art ___Coins ___Jewelry ___Bottle(s) of Wine __Other Tangible Item(s)

Intangible Items:__Gift Certificate(s) from Business or Proprietor (offer of Discounted Goods or Services)__Other Services ___Entertainment ___Accomodations ___Airfare ___Use of Facilities __Other Intangible Item(s)

Description of Item(s) __________________________________________________________________________________________

__________________________________________________________________________________________

S i lent/L ive Auct ion Donat ion Form Thank you for your support! Please use this form to document gifts of assets, materials, or

personal property to be used at our fundraising event. This may include functional event items that are used or consumed at the event as well as items to be auctioned. Program inclusion deadline: September 15th.

Donation Estimated Value: $_____________________________

Items can be mailed to or dropped off at CommuniCare Health Centers | 3066 E. Commerce, San Antonio, TX 78220

Attn: Development Department

For more information, please contact Jackie at (210) 233-7081 or jwingo@communicaresa.org

2 0 1 8 F U N D r A I S I N G g a l a th u r s d a y , o c t o b e r 1 1 t h l 6- 1 1 pm Foundation