Manitoba Sports Hall of Fame - Artifact Donation Assessment Form

Artifact Donation Review Form

Donor Inquiry Information

First name *

Last name *

Email *

Mobile *

Address *

City *

Country *

State/Province *

Zip/Postal code *

Type of Gift *

Indicate the intended category of donation for which these are to be considered.

Gift Bequest

Other

Please Input Each Item(s) for Review *

Item

Short Description

+ Add

History of Artifacts *

Please include any details that may help us in better consider these items (where it is from, who it belonged to, special uses, unique characteristics and history, age etc.)

Restrictions or Conditions of Use: *

Yes No

Please specify

*DISCLAIMER

This list is for initial review and consideration purposes only. Manitoba Sports Hall of Fame & Museum will contact you via email to follow up on the potential for acquisition of the items outlined in this form.

I have read and understand *

Signature*

Please sign or type your name below to agree to the above disclaimer and confirm that the list provided represents items that you are considering for donation to the Manitoba Sports Hall of Fame.