I'd like to donate an item for: *

Select an event

Gay Bingo: Over the Rainbow

Donor/Business Name *

(for event listing)

First Name

Last Name

Contact Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

The donated item is a: *

Physical item

Gift Certificate

Both

Please select one: *

It will be delivered, mailed or picked up by June 2, 2023

Certificate is being emailed to: kellyg@lifelong.org

Item needs a certificate made (provide details above)

I need this item picked up (select date below)

Pick-up date

if applicable, what date do you want your item to be picked up?

MM

DD

YYYY