Item Donation Form

Fields marked * require an entry.

GOD'S BLESSINGS TO YOU in advance for helping to make our auction successful! Any donation $500 or greater also receives free tickets. Please DO NOT purchase your ticket(s) online if you are eligible for free tickets. After validating the value of your purchase via a receipt, your free tickets will be available for pickup at the Immanuel Lutheran Church office. $500 = 2 Free tickets and $750 = 4 FREE tickets

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:*

Address:*

Address2:

City:*

State:*

Postal Code:*

Country / Location:*

At least one phone number is required.*

Mobile Phone:

Home Phone:

Email:*

Thank You to our Generous Supporters