Pace Dress Donation Form

Honoring the Female Spirit A Benefit for PACE Center for Girls, Lee County Tuesday, September 1, 2009 ● 6-9pm ● Embassy Suites, Estero Dress Donation Agreement DRESS INFORMATION Description: _________________________________________________________ ___________________________________________________________________ __________________________________________________Size: ____________ ESTIMATED VALUE: The value of the property must be assigned by the donor or be appraised by an independent appraiser. Choose one of the following options: Apparent value as assigned by donor $ ____________________________ Appraised value (attach copy of appraisal) $ ________________________   Delivery Date for pick-up: ________________________________ DONOR INFORMATION: The following information will appear in all donor listings unless the donor wishes to remain anonymous (see below). Name: ____________________________________________________________ Address: ___________________________________________________________ City: ________________________________ State: ________ Zip: ____________ Please check here if you wish to remain anonymous _________________________________________ Signature of Donor or Representative

________________ Date

_________________________________________ Signature of Drop-Off Location Representative

________________ Date

PACE, Inc. is a tax-exempt corporate entity as described in Section 501(c)3 of the Internal Revenue Code.