Fields marked * require an entry.

Thank you for supporting wish granting by donating wine to Wish Night!

Below are the partnership levels to choose from. Please note: If possible, bottles should be signed by the winemaker.

Important Deadlines:

January 15, 2025 –Wine donation commitment form deadline.
February 15, 2025 – Bottle delivery complete or pick-up arrangements made.

Large Format Level (If possible, bottles should be signed by the winemaker).

12 - 750 ml bottles valued at $30/bottle or higher to be featured in the Wine Wall.

AND

1 or more large format bottle(s) to be featured in the auction. Sizes can range from 1.5L – 15L.

Wine Wall Level

6 or more 750ml bottles valued at $30 or higher to be featured in the Wine Wall.

Winery Donation Form

Item Information

Item Name:*

Estimated Value $:*

Commitment Level (Please select one):

Item Description:*

Item Restrictions (blackout dates, etc.):

Winery Name:

I am a(n):*

Individual Donor

Business Donor

I would like to remain anonymous:*

Yes

No

Please indicate how you would like the donor listing to appear:*

By checking this box, I am indicating the item value listed is accurate at the time of donation to the best of my knowledge.:*

Yes

Certificate Donations

If your item donation is, or contains, a certificate, please select one of the following options:

I will mail a certificate to the office.

I will email a certificate to kverleye@akwa.wish.org.

I would like Make-A-Wish to create a certificate for me.

Item Delivery or Pick-Up

Donated wine must be received by February 15, 2025. Please indicate your preferences:*

I will send my wine donation. *Please email Kayla Verleye (kverleye@akwa.wish.org) for shipping instructions.

I will arrange for a drop-off.

I would like to arrange for a volunteer to pick it up.

Contact Information

Company:*

First Name:*

Middle Name:

Last Name:*

Address:*

Address2:

City:*

State:*

Postal Code:*

Country:*

At least one phone number is required.*

Mobile Phone:

Work Phone:

Email:*