By completing this form, you are agreeing to donate an auction item to our event on Saturday, April 22, 2017. In addition to supporting a worthwhile cause, you’ll also enjoy many benefits as an auction item donor. To be included in the event’s printed program, donations must be received by February 15, 2017.

For those donating a winery tour/tasting, we encourage you to include a bottle of wine with your tour/tasting as bottles of wine typically help to attract higher bidding to support this important cause.

Business Name (required)

Mailing Address, City, ST Zip (required)

Donor Contact (required)

Title (required)

Email (required)

Phone (required)

Fax

Item/Service Donated (required)

Auction Item Description
Information you'd like to be included in promotional material and/or auction bid sheet (required)

Item Value (required)

Item Expiration
Expiration will be listed as April 30, 2018 unless otherwise stated.

Restrictions

Please check one: (required)
Item and/or gift certificate will be shipped to the Lifehouse officeItem needs to be picked upPlease make a gift certificate on our behalf

If shipping an item, please indicate the estimated date of shipping

If an item needs to be picked up, please indicate location and contact name

Mailing Address
Lifehouse Agency
Attn: Great Chefs
899 Northgate Drive, Suite 500
San Rafael, CA 94903