Donation for La Belle Époque

Fields marked * require an entry.

To Donate an auction item, please complete the information below. Your item may be sold at either the Silent or Live auction. Items may be bundled into a package or with other auction items. Please note the donor information provided will be used in the MVM Directory Yellow Pages

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:*

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