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Please complete by September 29, 2023
Donor or Company Name
*
Donor Name
*
Company Name (if different)
Street Address
*
Address Line 2
City
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State
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
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
Washington DC
Zip Code
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Phone Number
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Email Address
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Gift Solicited By
Donor Signature
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clear
Donation Date
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Donor Website
Catalog Item Name (60 characters maximum)
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Item Description (300 characters maximum - quantity, size, color, date, restrictions or other information to ensure understanding of the item)
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Item Fair Market Value
*
Is your donation
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A physical item
A gift certificate
Gift Certificate Information:
Donor to Provide
Auction Committee to Create
Expiration Date
+
Are you delivering your item? Please indicate the delivery date.
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Please upload your company logo or donated item photo here. Please send in .jpeg or .png format .
Please upload your company logo or donated item photo here. Please send in .jpeg or .png format .
Any questions? Please contact Taylor Van Arsdall @ tvanarsdall@xcp.org