Illinois Head Start Association

First Name *

Last Name *

Email *

Raffle Basket Donation Form

Thank you for your support and generosity! Your donated raffle basket will help make our annual conference a success. Please complete this form to provide details about your donation.

Donor Information

Name of Individual or Organization:

Contact Person (if different):

Contact Number:

Email Address:

Mailing Address:

Basket Details

Description of Basket Contents: (Please list the items included, if known.)

Estimated Value of Basket:

Donation Logistics

How will the basket be delivered?
Choose 1

Drop-off/Mailing Information:

Baskets can be mailed or dropped off to:
Illinois Head Start Association
3435 Liberty Drive
Springfield IL 62704

Special Instructions/Notes:

Thank You!

Your contribution—whether a themed basket, gift card, or unique item—will add excitement and fun for attendees while supporting our efforts.

Every donation counts! Thank you for your generosity!

Annual Conference Raffle Basket Donation Form

Donor Information

Basket Details

Donation Logistics

Drop-off/Mailing Information:

Thank You!