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 Raffle Gift Information

Please provide the following information so that we may properly recognize those who
contribute to our Bluegrass Raffle.
 

Name of Business: ____________________________________________________________

Address:              ____________________________________________________________

                              _____________________________________________________________
 
Telephone #: _____________________ E-mail:______________________________________
 

Description of Raffle Item: _______________________________________________________
 
          _________________________________________________________________________
 
        __________________________________________________________________________

Estimated Value:   ________________________
 

Raffle Case:    ____   Guitar          ____   Banjo        ____   Mandolin
 
                           ____   Fiddle         ____ Grinner         ____   Any

DBA member who arranged donation:   _________________________________________
 

Tax Form Required by Donor?   ____ Yes   ____ No
 

Please return the form to your DBA representative. The DBA representative should
get the form and information to Betty Headrick (760-0745) as soon as possible.
Information can also be e-mailed to
mbheadrick@aol.com. Raffle items may be
given to Betty Headrick, Brooke Miner or Bonnie Lohman.
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