Family Services of the North Shore
Gift-in-Kind Donation Form

34th Annual Winter Family Ball
Sunday, December 1, 2019

Thank you for your donation to the Winter Family Ball auction.
To ensure we receive accurate information about your gift please complete the following form
and submit by October 15, 2019.

For donations requiring a gift-in-kind tax receipt please include your sales receipt or appraisal in a clearly marked envelope and attach with your donation or mail to:

Family Services of the North Shore Winter Family Ball,
# 203 – 1111 Lonsdale Avenue, North Vancouver, BC V7M 2H4

* Required Fields
Step 1 — Donor Information
Who contacted you? or How did you hear about our event?:

As it should appear for recognition purposes.


Suite/Street: *
City: * Province: * Postal Code: *


Title: First Name: * Last Name: * Position:
Email: *

Best # to reach you: * Alternate:

Step 2 — Donation Details
PLEASE SELECT ALL THAT APPLY: *  Merchandise Donation  Wine Donation  Gift Card

Provide key details and important information for our printed material and electronic communications.

FAIR MARKET VALUE: * $ (not including sales tax)

FSNS reserves the right to confirm any valuation with an independent appraisal.

Please list any restrictions pertaining to this donation. Unless otherwise specified,
the donation will start December 2, 2019.

Step 3 — Shipping Information

Unless specified, all donations other than perishables and live flowers must be
received by November 15th.

I will deliver my donation to Family Services on
My donation will be ready to pick up after

Branded gift bags, product information, or props are helpful to create an eye-catching display. Please label all props that are to be returned.

Step 4 — Tax Receipt Eligibility
Donation Agreement:

Thank you for your donation. Family Services of the North Shore reserves the right to package any donation with other items, promote the donation in the silent auction or raffle or may be used for future fund-raising activities.
Simple Spam Protection Question:
Registered Charities: FSNS Foundation 864745575 RR0001; FSNS Agency 119061240 RR0001

Thank you for your support! For further information please call Rebecca Anton at 604-988-5281