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Volunteers
Home
About Us
Directors & Staff
History
Press Releases
Contact Us
Events + Programs
Diabetes Program
Physical Therapy
Make a Donation
Volunteers
Donation Form Page
Borland Free Clinic is in need of individuals or businesses to donate experiences/physical items for the live and silent auction. If you are interested in donating to the event, please fill out this form. Borland Free Clinic appreciates all donations!
*
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Name
*
First
Last
Address
*
Please provide your address for future contribution tax purposes.
Phone Number
*
Please provide your phone number so we are able to contact you in the future.
Email
*
Please provide your email so we can contact you in the future.
Donation Item
*
Please provide the item name that you would like to donate.
Estimated Value
*
Please provide the estimated value of your donation item.
Description
*
If you would like to provide more information on your donation, please do so below.
Submit