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Densho Dinner 2019 Donation Procurement Form
Thank you for supporting the 2019 Densho Dinner! The event will take place on November 2 at the Meydenbauer Center in Bellevue.

Densho Contact information:
1416 S. Jackson Street / Seattle, WA / 98144
Jen Fukutaki (jen.fukutaki@densho.org)
Danielle Higa (danielle.higa@densho.org)
206.320.0095 ext. 102

Densho is a 501(c)(3) non-profit organization with tax ID# 91-2164150

Name of Donor: *
Your answer
Name of company to be listed in the Densho Dinner program (if applicable):
Your answer
Address (city, state, zip): *
Your answer
Phone number: *
Your answer
Email address: *
Your answer
Describe the donation. Please include restrictions, pertinent dates, number of people, etc. *
Your answer
Donor-state fair market value: *
Your answer
Mark one: *
If item will be delivered to the Densho office, please provide the name and phone number of the person who will drop it off:
Your answer
If Densho needs to pick up the item, please provide contact information, location, and date by which it needs to be picked up (no later than October 18):
Your answer
Is there any other information about the item or getting it to Densho that you would like to share?
Your answer
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