EmailMeForm
Fight Club Survivor's Boutique Donation
Print Completed Form and Mail to:
10424 N 14500E Rd., Grant Park, IL 60940.
God bless you.
*For a lesser cost, remove items from their packaging.
Name
*
First
Last
Condition of Item(s) Donated
*
New
Lightly Used
Please let us know which items you will be donating.
*
Wigs
Wig Care Products
Wig Stand
Bras
Breast Forms
Head Cover: Hats, Scarf, Wrap
Post Op Clothing
Swimwear
Other
If You Chose Other, Please Write It Here...
Donating In Honor or Memory of a Loved One? If you have chosen in Honor or Memory below, PLEASE be sure to include the person's name below.
*
Honor
Memory
Not Applicable
In Memory/Honor of:
By adding your loved one's name above, you are giving us the approval to share your loved one's name and also your name as the one who has donated "In Honor/Memory" of.
Your Email for Receipt
This is only to email a receipt.
Would you like us to charge for your donated item?
*
Yes
No
*Some who have donated boutique items have requested that we ask for a donation for their item(s). This monetary donation is then kept by the organization as that person's monetary donation.
If We Should Charge for Your Donation, Please Inform Us of the Amount(s) per Item.
Item Name / Amount
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