Fields marked * require an entry.

Procurement Form

Each family is expected to procure $200 in goods and/or services. All individual items must be valued above $60 ($25 for gift cards).

The Procurement Deadline is Friday, December 2nd. After this date,

only a cash donation of $300 will be accepted to fulfill your procurement requirement.

Procurement Form

Item Information

Item Name:*

Estimated Value $:*

Item Description:*

Solicitor's Name (if different from Contact Name):

I am a(n):*

Individual Donor

Business Donor

I would like to remain anonymous:*

Yes

No

Contact Information

Company:*

First Name:*

Middle Name:

Last Name:*

At least one phone number is required.*

Mobile Phone:

Home Phone:

Work Phone:

Email:*