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Masquerade Gala
Benefitting LWGA Rally for the Cure
Wine Bottle(s) Donation for Wine Grab Event
RETAIL VALUE(S): $
(Bottle of wine should be valued between $25 to $100)
Donated Item
Brand Name, Type of Wine & Year:
Donor Information
Name:
Business Name:
Address:
Phone:
Email:
Would you like to remain anonymous: ☐ Yes ☐ No
How will the wine be delivered to the Lantana Ladies League: ☐ Drop Off ☐ Pick Up
Bottle Received:
Check/Cash Donation Received:
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www.lantanaladiesleague.com
5013(c) Federal Tax ID 84-1675092