Donation Form

Please use the form below to let the Auction Committee know of your intention to donate an item or service to the 2008 QHR Wea Auction. An auction committee member will contact you to confirm your donation. If the donation is from multiple donors, please list additional donors in the "comments or restrictions" area. If you have any questions, please contact Dana Foote.

* = Required Field

Donor Information
* First Name: Required
* Last Name: Required
Business Name:
Spouse First Name:
Spouse Last Name:
* Email: RequiredInvalid format.
Phone:
Address:
City:
State:
Zip:
Donor wishes to remain anonymous

Gift Information
* Retail Value: Required
* Description: Required
Auction Committee to make certificate for item
Comments or Restrictions:
 


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