The Stellar Ball Silent Auction Donation Form

The Stellar Ball Silent Auction Donation Form
Donor Name

PrefixFirst NameLast Name
Please fill the list below.*
Expiration Date (If Applicable)

MonthDayYear
Date
Point of Contact Name

First NameLast Name
Solicitor Name

First NameLast Name
Donor's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email Address
example@example.com
Pickup Date

MonthDayYear
Date
Pickup Details
Additional Notes/Special Instructions
Please select one.

I am enclosing/emailing a gift certificate.I will forward certificate at a later date.Please generate a certificate for me.Please contact me to pick-up item.
Auction Contact:

PO Box 290897, Columbia, SC, 29229

803-805-2525 | admin@empowringjustice.org
Should be Empty: