Auction Item Donation

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Thank you for your support of EvergreenHealth's ARU with the donation of an auction item. Please complete the form below. If you have any questions, please contact Tracie Ziegler at 425.899.1908 or tmziegler@evergeenhealth.com

Item Information

Item Name:*

Estimated Value $:*

Item Description:*

Notes:

I am a(n):*

Individual Donor

Business Donor

I would like to remain anonymous:*

Yes

No

Contact Information

Company:*

First Name:*

Middle Name:

Last Name:*

At least one phone number is required.*

Mobile Phone:

Home Phone:

Work Phone:

Email:*

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