Swag Bag Donation Form

Rockin’ for the Homeless 5k Run/Walk A FAMILY FRIENDLY EVENT BENEFITING UNION STATION HOMELESS SERVICES

Please print all information below and attach any gift certificate(s) with a detailed description of the item (e.g. model, rarity, quantity, restrictions)

 Gift certificate enclosed  Item available for pick up – please contact to schedule Date: Description of donation (Min. amount 200):

Gift Restrictions:

Expiration of Donation (if applicable):

Estimated value of donation: $

Donor name: Note: All contributions to Union Station Donor address: Homeless Services are tax-deductible to the fullest extent permitted City: by law. Union Station’s non-profit Tax ID # is 95-3958741

Telephone:

State:

ZIP:

Email:

Contact for pick up:

Please mail or fax to: Union Station Homeless Services

825 E. Orange Grove Blvd., Pasadena, CA 91104

www.unionstationhs.org

fax:626.798.1640