Biloxi

Shuckers Donation Request Form

The Shuckers are happy to support charitable organizations to positively impact our community through
donation of tickets or memorabilia. No monetary gifts will be given. Please complete the following
information and return via mail or fax at least 4 weeks prior to the event along with a letter on the
organizations letterhead requesting the donation:
Biloxi Shuckers-Donation Request
PO Box 173
Biloxi, MS 39533
Fax 228-206-6187

Ocean Springs Ladies Auxiliary BPOE 2501
Organization Name:__________________________________________________________________________________

228-861-9789 / 219-6567
Contact:___________________________________________________
Phone:__________________________________
Janan Holland / Chris Brosseau

p.o. Box 767
Organization Address:________________________________________________________________________________

Ocean Springs, MS 39566
City, State, Zip Code:_______________________________________________
Fax:______________________________

nostamps@hotmail.com
Contact E-mail_________________________________________________ 501 (C) (3)#:__________________________

Annual Draw Down
Event Name:________________________________________________________________________________________

150-175
Event Date and Time:___________________________________________
Projected Attendance___________________
7-18-15 6:30 PM

Door Prize
Item To Be Used For (Door Prize, Silent Auction, Live Auction, Etc.):____________________________________________


For Office Use Only:

Date Received______________________________________________ Status: ______ Accepted ______ Declined

Called/or
Reply
Sent
to
Organization:____________________________________
Date:___________________________

Item Donated:______________________________________________________________________________________

Item Picked Up By:____________________________________________________ Date:_________________________




Signature

Janan Holland