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Donate an Auction Item

Item Information

Item Name:*

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Estimated Value $:*

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Please enter a valid decimal number as nnn.nn

Item Description:*

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Item Restrictions: Please list date/s available and/or specific expiration date if other than April 18, 2021. Note also if winner needs to contact donor to make arrangements:

I am a(n):*

Individual Donor

Business Donor

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I would like to remain anonymous:*

Yes

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Donor Acknowledgement: List either business name OR list individual / couple's first and last name. If multiple donors, list all names:

Business website (if applicable):

Did you donate the same item to last year's auction?

Yes

Item Status:

Gift certificate or item donation accompanies this form

Donation to be delivered/mailed to Langley

Please have auction team create a certificate (to include all necessary details).

Please have someone contact donor to arrange donation pickup.

Is there anything else you would like to tell us about your donation?

For Office Use Only: :

Contact Information

Company:*

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First Name:*

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Middle Name:

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Last Name:*

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Address:*

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Address2:

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City:*

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State:*

Province State is required for the United States

Postal Code:*

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Country / Location:*

Country is Required

At least one phone number is required.* Please enter at least one phone number

Mobile Phone:

Please enter a value for Mobile Phone: Please enter a valid phone number. Use x to denote extension

Home Phone:

Please enter a value for Home Phone: Please enter a valid phone number. Use x to denote extension

Email:*

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