Thank you for your donation!

We’re excited to have your auction donation for our October 26, 2025 event. Your donation goes directly to supporting our organization and mission.

Please fill out the form below with your information.

Brief description of item:

Value of gift $ (good faith/fair market value)

Donated by

Check to remain anonymous

Phone

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Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

*Detailed Description or Restrictions of Gift: Please be specific including dates, times, limitations, expiration dates, etc. Donor agrees that this donation becomes the property of The PEWC and may be packaged with other items to be sold at the auction or raffle. If you have questions, please contact us: info@thepewc.org

Item pickup or delivery

Please indicate how the item will be received. Note: All items must be received no later than September 25th.

Item/certificate will be delivered by donor to PEWC.

Item/certificate needs to be picked up.

Item/certificate received. (FOR INTERNAL USE.)

How did you hear about us?

The Parkinson’s Exercise and Wellness Center

3660 W. 95th Street

Leawood, KS 66206

913-276-4665

info@thepewc.org

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