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Gala Auction Donation Interest Form -
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Donor Information
Please enter the following information to submit a Gala Auction Donation item/experience for consideration for the September 24th, 2022 Habitat Gala.
Your name
*
First
Last
Please enter your name or the name of the primary contact person for this auction item donation.
Phone
*
Cell phone or best contact number
Email
*
Donor name(s) (as you would like it to appear on the program)
Company or individual. If multiple donors involved in this item, please list all names that should appear.
Please check if you wish to remain anonymous
Address
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Donation Information (Please add a detailed description of the donation)
*
Photos/Visuals of Auction Item (Please share any relevant photos of the auction item/experience. If this item is donated by a business, please include your company's high-res logo in this section as well)
Click or drag a file to this area to upload.
Click or drag a file to this area to upload.
Click or drag a file to this area to upload.
Click or drag a file to this area to upload.
Fair Market Value
*
Please list the Fair Market Value of this item/experience. The Fair Market Value is what this item would traditionally sell for. If there is no associated value, please put n/a.
Expiration Date
*
If this item must be redeemed by a certain date, please share when it would expire for redemption.
Restrictions/Blackout dates (if applicable)
*
If there are booking restrictions/blackout dates for when this item cannot be redeemed (such as for a vacation or type of experience), please list those restrictions here.
Redemption Instructions:
*
How the auction item winner will redeem this item/experience? Who will they contact and what should they do?
Item Delivery
*
I will deliver or ship this item to Habitat
I will need this item picked up (must be available for pick-up at least two weeks before event and within 35 miles from the Habitat offices)
N/A no tangible item (Habitat can generate a certificate)
Habitat or Gala Committee Contact
Please enter a name of a Habitat staff person or volunteer who you have been in contact with regarding this auction item (if applicable).
Signature of Donor
Clear Signature
Please sign this form. Donation deadline is August 10, 2021. A member of our team will be in touch within 7 days.
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