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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

Is your donation an Item, Gift Card/Certificate or an Item AND Gift Card/Certificate?*

If you donation is a Gift Certificate, do you need MHCCF to create it for you based on the description you have provided here?

Yes

No

Please list here any specific information you would like the bidder to know such as restrictions, expiration, black out dates, model numbers, website, etc.?

How will MHCCF receive your donation?

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:*

Donate an Auction Item

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