Toppers for Troopers Contract - Encore Ballroom Couture Encore Ballroom Couture

This Donation Contract is valid for all donations of new or like new hats, skull caps, scarves, hairpieces, clip-in extensions, clip-in bangs, and wigs.
If you need assistance or have any questions, please call the Dress Studio at (703) 573-1640.

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Step 1 of 2 - Contact Info

Contact Information

Name*

First Last

Email*

Preferred Number*

Home

Work

Cell

Home Phone

Work Phone

Cell Phone

Do you have a second phone?*

Yes

If we can't reach you at your preferred number

Second Phone*

Item Details

Item #1

Type*

Description*

Condition*

New Item

Like New Item

If "Like New" I certify this item is clean:*

Yes

Approximate Value*

Receiving Documentation

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Terms & Conditions

PROCEDURE

1) Fill out the Donation Contract and submit. A copy of the contract will be emailed to you upon submission.

2) Print and enclose a copy of your Donation Contract inside the box with your items being donated. If donating hair items, please place them in individual plastic zip top bags within one box for shipping.

3) You are responsible for your shipping costs to Walter Reed National Military Medical Center. Please send your items with a tracking number, so they may be located at any time. Ship your items directly to:

Walter Reed National Military Medical Center
Attn: Stacey Vitiello
8901 Rockville Pike
Building 19, Room 3718
Bethesda, MD 20889

4) Email the tracking number to stacey.d.vitiello.civ@mail.mil AND EncoreBallroomCouture@gmail.com so that we may keep an eye on the shipment – All shipments must have a tracking number!

5) If you have any questions about how to donate, contact Encore Ballroom Couture directly at (703) 573-1640 or by email at EncoreBallroomCouture@gmail.com. If you have any questions about items that have been donated, please contact Stacey Vitiello at WRNMMC at (301) 400-1258 or by email at Stacey.d.vitiello.civ@mail.mil.

NOTE: Once your item(s) have been received and processed by WRNMMC, you will receive correspondence from them directly.

SHIPPING INFORMATION

You are responsible for your shipping costs to Walter Reed National Military Medical Center. Please send your items with a tracking number, so that your items can be located at all times.

Please ship your items to:

Walter Reed National Military Medical Center, Attn: Stacey Vitiello, 8901 Rockville Pike, Building 19, Room 3718, Bethesda, MD 20889

CLAUSES

1) ENCORE BALLROOM COUTURE LLC will not be held liable for any injury or malfunction encountered due to items donated.

2) ENCORE BALLROOM COUTURE LLC will not be held liable for any items lost during shipping.

3) All donations once submitted to Walter Reed National Military Medical Center (WRNMMC) are final, and will not be returned under any circumstances. Once received by WRNMMC, the items mentioned in this Donation Contract become the sole property of WRNMMC.

4) ENCORE BALLROOM COUTURE LLC cannot be held liable for the condition of the items.

5) All items submitted under this Donation Contract will be held to this agreement and these terms.

6) This Donation Contract is strictly between you and ENCORE BALLROOM COUTURE LLC.

7) There will be complete confidentiality concerning all personal information provided to ENCORE BALLROOM COUTURE LLC however, you authorize us to provide information outlined in this Donation Contract to WRNMMC, for the sole purposes of allowing the program to document the donation and provide you with a written response.

8) Julie Wilson as Owner of ENCORE BALLROOM COUTURE LLC, reserves the right to make all final decisions in all matters concerning ENCORE BALLROOM COUTURE LLC and the donation program Toppers For Troopers.

9) ENCORE BALLROOM COUTURE LLC abides by the rules and regulations of the State of Virginia. Any court action brought forth or involving ENCORE BALLROOM COUTURE LLC or the donation program Toppers For Troopers must be presented and resolved in Fairfax County, in the State of Virginia.

By clicking submit you agree to all the Terms and Conditions set forth in this Donation Contract. You verify that you are of legal age (18 years or older). All donations once submitted to Walter Reed National Military Medical Center (WRNMMC) are final, and will not be returned under any circumstances. Once received by WRNMMC, the items mentioned in this Donation Contract become the sole property of WRNMMC.

It is encouraged but not required to include a generic note of encouragement that will be shared with patients.

Comments

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