Donate an Auction Item

Fields marked * require an entry.

If you have an item, service, or experience you would like to donate to the Gala, you can use this form or contact Hanna Calleri at president@jacksonedhpto.org.

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:*

At least one phone number is required.*

Mobile Phone:

Home Phone:

Work Phone:

Email:*

About Us

Contact Us

Follow Us

Sponsors

About Us

Contact Us

Follow Us