Fields marked * require an entry.

Donate an Auction Item

Item Information

Item Name:*

Estimated Value $:*

Item Description:*

Restrictions/expiration date/special instructions:

I am a(n):*

Individual Donor

Business Donor

I would like to remain anonymous:*

Yes

No

Donor Acknowledgement: List either business name OR list individual / couple's first and last name. If multiple donors, list all names:

Person to contact regarding donation logistics (if applicable):

Business website (if applicable):

Did you donate the same item to last year's auction?

Yes

No

Status of Donation:

Item to be delivered/mailed

This form serves as gift certificate

Is there anything else you would like to tell us about your donation?

Contact Information

Company:*

First Name:*

Middle Name:

Last Name:*

Address:*

Address2:

City:*

State:*

Postal Code:*

Country / Location:*

At least one phone number is required.*

Mobile Phone:

Work Phone:

Email:*