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Auction Item Donation

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

Item Delivery

How would you like your donation item to be received?*

Address for item pick-up:

Contact Information

Company:*

First Name:*

Middle Name:

Last Name:*

At least one phone number is required.*

Mobile Phone:

Home Phone:

Work Phone:

Email:*

Digital Certificates: Please email to BOMFGala@backonmyfeet.org.

Mail Auction Items: BOMF Gala, Attn: Abby Friedman, 170 West End Ave 7F, New York, NY 10023

Items to Be Picked Up: Please email BOMFGala@backonmyfeet.org to confirm pick-up time and date.