Auction Donor Form

Fields marked * require an entry.

The deadline for donations is Tuesday, January 26, 2016

Fill out this form for each item donated.

If you have questions about filling out this form, please email auction@pacificprimary.org

Item Information

Item Name:*

Estimated Value $:*

Item Description:*

RESTRICTIONS (time limitations, PP families only, Count-Me-In with total # of participants, etc.):

I am a(n):*

Individual Donor

Business Donor

I would like to remain anonymous:*

Yes

No

Child's name/classroom or Family who solicited donation:*

Item Category

Item Category:*

Item Delivery/Drop off Details

Item Type/Delivery:*

Delivery Details (Estimated delivery date, special arrangements needed, is it bigger than a breadbox, etc):*

For Pacific Primary Community Only?*

Yes

No

Business Details (if solicited from a business: include name, a contact at business and address, phone and URL):

Contact Information

Company:*

First Name:*

Middle Name:

Last Name:*

At least one phone number is required.*

Mobile Phone:

Home Phone:

Work Phone:

Email:*