Donate a Proximity Prize

Fields marked * require an entry.

Donate a Proximity Prize

If you would like to donate a proximity prize to be used at this golf outing, please fill out the form below and we will contact you with any questions.

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

Contact Information

Company:*

First Name:*

Middle Name:

Last Name:*

At least one phone number is required.*

Mobile Phone:

Home Phone:

Work Phone:

Email:*