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Please fill in the Auction Item Information and Donor Information.

Please indicate any restrictions, special instructions and name of committee member who solicited the item where applicable.

Donate an Auction Item

Item Information

Item Name:*

Estimated Value $:*

Item Description:*

Restrictions, special instructions and name of solicitor if applicable:

I am a(n):*

Individual Donor

Business Donor

I would like to remain anonymous:*

Yes

Contact Information

First Name:*

Middle Name:

Last Name:*

Address:*

Address2:

City:*

State:*

Postal Code:*

Country / Location:*

At least one phone number is required.*

Mobile Phone:

Home Phone:

Work Phone:

Email:*