Fields marked * require an entry.

If you would like to donate items and/or services to the Gala, please complete the below form and let us know in the Notes section if you will be mailing the item to us, would like us to come pick it up, or you would like us to create a certificate for it. Or you can print and complete this Judge Memorial Auction Donor Form .pdf to accompany your donation.

Thank you so much for your generosity!

Item Donation

Item Information

Item Name:*

Estimated Value $:*

Item Description:*

Notes:

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:*

Address:*

Address2:

City:*

State:*

Postal Code:*

Country / Location:*

At least one phone number is required.*

Mobile Phone:

Home Phone:

Work Phone:

Email:*

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Item Donation

Thank You to Our 2016 Gala Sponsors

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