CIM Donation Form

Donor Information
Donor Contact*
Organization Name Title
Address*
Street Address City State ZIP Code
Donation Information
Donation Item*
Short Description of Donation Item*
Full Description of Donation Item*
Please include detailed description of your product, service, trip or other item, including model number if applicable.
Is shipping included?*
- Yes
- No
- My donation item does not require shipping
Estimated Value*
Date by which item must be claimed (if any)
Date Format: MM slash DD slash YYYY
File Upload
Please upload a high-res company logo as well as a high-res image of your donation item.
Drop files here or

Accepted file types: jpg, jpeg, png, gif.
Additional Information
Are you exhibiting at the 2022 World of Concrete?
- Yes
- No
For tax purposes, which year would you like your donation recognized:
- 2021
- 2022
What is your booth number?
Who should winning bidders contact to arrange to claim/use your donated item?
Please leave blank if the contact information is the same as the donor contact above.
Name Phone Email

Donor Information