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Fields marked * require an entry.

Please fill out the form below to donate an item for our silent or live auction.

Thank you for supporting St. Agnes!

Please put in the notes if you would like for us to pick up your donation.

Silent Auction Item Donation

Item Information

Item Name:*

*Please enter a value

Estimated Value $:*

*Please enter a value
Please enter a valid decimal number as nnn.nn

Item Description:*

*Please enter a value

Notes:

I am a(n):*

Individual Donor

Business Donor

*Please enter a value

I would like to remain anonymous:*

Yes

*Please enter a value

I would like for St. Agnes School to pick up my donation:

Yes

I will drop my donation off at St. Agnes School:

Yes

My donation will need a certificate created by St. Agnes School:

Yes

Please add pickup, delivery, and any other details that St. Agnes school should know about the fulfillment of this donation:

Contact Information

Company:*

Please enter a value for Company:

First Name:*

Please enter a value for First Name:

Middle Name:

Please enter a value for Middle Name:

Last Name:*

Please enter a value for Last Name:

Address:*

Please enter a value for Address:

Address2:

Please enter a value for Address2:

City:*

Please enter a value for City:

State:*

Province State is required for the United States

Postal Code:*

Please enter a value for Postal Code: Please enter a valid postal code.

Country:*

Country is Required

Mobile Phone:

Please enter a value for Mobile Phone: Please enter a valid phone number. Use x to denote extension

Home Phone:

Please enter a value for Home Phone: Please enter a valid phone number. Use x to denote extension

Work Phone:

Please enter a value for Work Phone: Please enter a valid phone number. Use x to denote extension

Email:*

Please enter a value for Email: Please enter a single valid Email.

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