APDA RI MOH Silent Auction Donation Form

Rhode Island Magic of Hope Gala & Auction Item Donation Form

This form is to donate an item to be used in the Silent or Live Auction on March 12, 2027, at the Omni Providence in Downtown Providence.
Donated Item(s) Information:
For Live Auction items, if bidding goes for value, are you willing to double your donation?
Donor Name

First NameLast Name
I would like to remain anonymous:
Donated by: Individual or company name that you want to appear in the program
Contact Name (if different from donor)

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Donor Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Select Item Delivery Method: Please select one.
Upload the Item Certificate

Cancelof
If available, upload a photo of the item

Cancelof
Item will be delivered to APDA Rhode Island no later than

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Item will be available for pickup after

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Pickup Details
Additional Notes/Comments About Donated Item(s)
If donating more than one item, please start your comments with the name of the item.
Auction Mailing Address & Contact:

APDA Rhode Island Chapter
PO Box 114098
North Providence, RI 02911

Questions??
apdari@apdaparkinson.org | 401-439-8435

All donations are tax-deductible to the extent allowed by law. Please retain a copy of this form for your records.
American Parkinson Disease Association Federal Tax ID# 13-1962771

If possible, please mail or arrange for the pickup of the item(s) no later than February 1.
Should be Empty:

Rhode Island Magic of Hope Gala & Auction Item Donation Form