Auction Items

For additional information about the auction please contact Dave Adler at Email Dave.

Are you interested in donating an auction item this year? If so, fill our the form below and one of our event committee members will be in touch shortly!

Do you have something fun or unique to donate? Please complete the fields below.

*1.

Question - Required - Donor /Business Name (for program recognition)

Question - Not Required - Name of Contact Person (if different from donor)

Contact Information:

Name:

First Required	Last Required

Email: Required

Street 1: Required

City/State/ZIP:

City Required	State Required	ZIP Required

Phone Number: Required

Please email me event-related information so I can participate successfully.

Yes, I would like to receive postal mail regarding my participation in this American Cancer Society event.

Remember me. What's this?

Question - Not Required - Donor Fax

*5.

Question - Required - Donation (only item can be listed per submission)

*6.

Question - Required - Description of Item (for program) (indicate any limitations, restrictions, blackout dates, expiration dates) *Please note: There are no guarantees regarding page placement in program.

(Maximum response 255 chars, approx. 5 rows of text)

*7.

Question - Required - Value of Donation (please provide good best estimate)

Question - Not Required - Solicitor's Name

Question - Not Required - Solicitor's Phone Number

10.

Question - Not Required - Solicitor's Email

11.

Question - Not Required - Item will be mailed by (MM DD YY)