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Donate an Auction Item

Item Information

Item Name:*

Estimated Value $:*

Item Description:*

Notes:

I am a(n):*

Individual Donor
Business Donor

I would like to remain anonymous:*

YesNo

Is your donation an Item, Certificate or Both an Item AND a Certificate?*

If your donation is a certificate, do you need Friends of Hospice to create one for you?*

YesNo

If your donation is a certificate, does it have any restrictions (i.e. expiration dates, blackout dates, special notes)?

Contact Information

Company:*

First Name:*

Middle Name:

Last Name:*

Address:*

Address2:

City:*

State:*

Postal Code:*

Country:*

At least one phone number is required.*

Mobile Phone:

Home Phone:

Work Phone:

Email:*