Item Donation

Fields marked * require an entry.

Donate an Item to our Promise Celebration Gala Auction!

Please note that medical services, cosmetic procedures, diabetes management tools, and items on consignment are not accepted in our auction. JDRF accepts new and unused items. If you have any questions, please contact our office at (616) 957-1838. Thank you!!!

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:*

2011 Promise Celebration Sponsors