Silent Auction Donation Form

Please complete this form if you are donating to our silent auction. Thank you!

Kids’ Chance of Ohio
Federal Tax Number 26-0216888

Donor's Full Name (name to be recognized): *
Contact Name: *
Company (If applicable):
Donor's Physical Address: *
City/ST/Zip: *
Phone: *
Email: *
Donation Description (use separate forms for each donation; be very detailed) *
Retail Value: *
Cash donation amount (if donating cash):
Attachment (If you have a document to support this donation, attach here):
Please upload your company logo so we can properly recognize your donation. *



Fields marked with * are required.

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2022 Ohio Self-Insurers Association| All Rights Reserved
PO Box 1073 | Columbus, OH 43216 | info@ohioselfinsurers.org | 614-340-3530
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