Online Auction Donation Form

How would you like the donor name to be listed?

Is this a business or individual?

Business Website

Name of Contact

Contact Phone:

Email:

Address for Donor

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

Brief description of item(s) being donated and other important information:

Approximate retail value:

Check all that apply

Dimensions?

Any restrictions (ex: expiration date, blackout period, etc.)?

Is it acceptable to use your logo and images from your website (if applicable) to advertise your item(s)?