Heart of Hawai'i Auction Donation Form

Heart of Hawai'i Auction Donation Form
We would like to invite you to participate in our Heart of Hawai'i auction with a tax-deductible auction donation to the Heart Ball. Contact ahahawaii@heart.org for any questions.
Donor/Company Name*
Contact Person's First and Last Name*

First NameLast Name
Contact Person's Email Address*
Contact Person's Cell Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Item Name*
Item Dollar Value*
Description of Item:
Provide details like: quantity, size, color, material, dates, number of people & other information to ensure proper understanding of the donated item.
Expiration date (if any)
Please date certificates valid one year minimum from date of Heart Ball.
Restrictions and Limitations
Image Upload (optional)

If you have an image of the item, please upload here.
Cancelof
Item Delivery*

We will deliver to AHA OfficeWe need our item picked up
If you need your item picked up what date will it be ready?
If you would like us to prepare a certificate for your item, please give us the name and phone number of the person the winning bidder should contact:
Should be Empty: