2025 State Convention Donation Form

Breaking Barriers-Change Starts With Us 2025

Please fill out, make a copy for your tax records, and return to:
National Federation of the Blind of Arkansas
c/o David Henry
P O Box 3441
Bentonville, AR 72712
Email: Rockinh57@cox.net
(479)426-7993

All required fields are marked with a *

DONOR INFORMATION

Donor Name (as you want it to be recognized) Donor Name (as you want it to be recognized)

First Name First Name

Last Name Last Name

Street Address Street Address

Address Line 2 Address Line 2

City City

State/Province State/Province

ZIP Code ZIP Code

Phone Number Phone Number

Email Address Email Address

DESCRIPTION OF DONATION

Please write a description of the donated item Please write a description of the donated item

Estimated Retail Value of Donated Item Estimated Retail Value of Donated Item

Restrictions, Special Instruction or Notes (if applicable) Restrictions, Special Instruction or Notes (if applicable)

National Federation of the Blind of Arkansas Tax I.D.:

71-6057788

2025 State Convention Donation Form

2025 State Convention Donation Form

DONOR INFORMATION

DESCRIPTION OF DONATION

National Federation of the Blind of Arkansas Tax I.D.:

Subscribe to
Arkansas Mailing List

Contact Us

Connect with Us

2025 State Convention Donation Form

2025 State Convention Donation Form

DONOR INFORMATION

DESCRIPTION OF DONATION

National Federation of the Blind of Arkansas Tax I.D.:

Subscribe to Arkansas Mailing List

Contact Us

Connect with Us

Subscribe to
Arkansas Mailing List