Item Donation

Fields marked * require an entry.

Item Donation

Please bring or mail your donation to the
Hotel Captain Cook
Call Rayli for details: 276-6000

If you are unable to drop off or mail,
please call CSS at 222-7324 and we will arrange for pickup

Item Information

Item Name:*

Estimated Value $:*

Item Description:*

Notes:

I am a(n):*

Individual Donor

Business Donor

I would like to remain anonymous:*

Yes

No

Item Drop Off

Will you be dropping off or mailing your donation to Hotel Captain Cook?

Yes

No

Contact Information

Company:*

First Name:*

Middle Name:

Last Name:*

Address:*

Address2:

City:*

State:*

Postal Code:*

Country / Location:*

At least one phone number is required.*

Mobile Phone:

Home Phone:

Work Phone:

Email:*