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Item Donation

Item Information

Item Name:*

Estimated Value $:*

Item Description:*

Notes, restrictions, expiration dates, does the winner need a letter, ticket or certificate to redeem the item, will the item be delivered or need to be picked up, etc.:

I am a(n):*

Individual Donor

Business Donor

I would like to remain anonymous:*

Yes

No

Contact Information

Company:*

First Name:*

Middle Name:

Last Name:*

At least one phone number is required.*

Mobile Phone:

Home Phone:

Work Phone:

Email:*

Item Donation

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