Raffle Item Donation

First & Last Name*

Company Name

Email

Phone*

Item to be Donated*

Item Value

Item Pick Up*

I will drop my item off at Countryside

I will mail my item

I will drop my item off with Sonja Ross

I would like my item picked up

All items must be obtained no later than May 8th. If item needs to be picked up, a staff member will reach out to you directly via phone. Thank you for your donation!

3310 S Cornhusker Drive

York, NE 68467

(402)200-3971

(402)205-1421

info@countrysidepd.com

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