2021 Discovery Ball - Auction Item Donation

2021 Discovery Ball

Auction Item Donation
Donated Item(s) / Experience(s): *
Donated Item(s) Estimated Value: *
Donated Item(s) Description: *
Donated Item(s) Restrictions: *
Please list any restrictions (i.e. expiration dates, blackout dates, etc.) or write "n/a". All items donated will be used in auctions benefiting the American Cancer Society.
I am a(n): *

Individual Donor Business Donor
Donor Name/Business: *
I would like to remain anonymous: *

Yes No
Donor Contact - Name: *

First Name Last Name
Donor Contact - Email: *
Donor Contact - Phone Number: *

Area Code Phone Number
Donor Address: *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Solicitor's Name: *
Item Delivery: *

Certificate will be uploaded. Certificate will be emailed to Chris Way at chris.way@cancer.org. ACS has my permission to create a certificate (if no certificate will be provided by the donor). Item or certificate will be mailed to Chris Way, ACS (812 W. Waveland, Apt #2, Chicago, IL 60613) by September 2, 2021. Item or certificate will be mailed directly to the winner after the auction concludes on October 2, 2021.
Certificate Upload

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If you would like, upload the item/ experience certificate. Cancel of
Please submit up to five (5) images or logos for the donated item/experience if you would like. Thank you for your support!
Image/ Logo #1

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Image/ Logo #2

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Image/ Logo #3

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Image/ Logo #4

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Image/ Logo #5

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Notes
Should be Empty: