DONATION FORM

August 12, 2013

Thank you for contributing an item for DRBA's Art in Nature Auction. One hundred percent of the proceeds will support outdoor recreation, environmental education and conservation in the basin, which includes communities in North Carolina and Virginia.

Please complete the following form so that we may describe your donation and send a tax letter acknowledging your donation + your ticket to the auction event!

Artist Name

Donor Name (if different from artist)

Description of donated item

Approximate Value of Donation $

Artist or Donor Mailing Address (for receipting and Auction invite)

Please list the name of the artist or donor the way it should appear in the auction catalog and promotional materials:Artist or Donor e-mail address for updates, as needed

I wish my donation to be anonymous YES NO

Thank you! Please complete and return this form to: Art in Nature Auction, Dan River Basin Association, 413 Church Street Eden NC 27288 or fax to 336 627 7206 or email to: nbell@danriver.org