GRC Silent Auction Donation Form
Please complete this form by Friday, October 18, 2024
Name
*
First Name
Last Name
Email
*
example@example.com
Hospital/Organization Name
*
Item I will donate:
*
Description of Item donated (1-2 sentences):
*
Value of donated item (must be $75 or more)
*
Is this a personal donation or donation made by your hospital or organization?
*
Please Select
Personal
Company
Will you bring the item to Fall Conference on October 30 or mail by October 15?
*
I will bring it along to Fall Conference with me
I will ship it; please send me the mailing address
Submit
Should be Empty: