Donations

Please consider donating to our Auction. Contributions of jewelry, week long or weekend use of your vacation property, gift certificates, fine art, personal services, sports tickets or memorabilia will be deeply appreciated.

If you are interested in donating an item, please use the form below. Your information will be forwarded to the auction coordinator. If you would like to donate multiple items, please use a separate form for each item. If you have any questions, please call (757) 873-6668 ext. 1122 or email us.

Donor Name *

Donor's Company Name

Address *

City *

State: *

Zip Code *

Phone * () - ext. (if any)

Email *

Verify Email *

Type of Donation * Gift Certificate Merchandise Other

Description of the Donated Item(s):

Fair Market Value
(in dollars) *

Receiving the Donation: * Donation Enclosed Donation to be Picked Up Donation to be Mailed

Donor's Displayed Name *
Enter the name as you want it to appear in program and advertising materials. If you do not wish to be recognized, please enter "Friend" and your donation will be recognized as given by a Friend of the Patient Advocate Foundation.

Please type the characters you see into the space below.
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