Illinois Head Start Association

Annual Conference Raffle Basket Donation Form

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!