Auction Item Donation

Fields marked * require an entry.

While PJA appreciates every contribution, in fact not every item is appropriate for our auction. For that reason, PJA
reserves the right not to accept any donation that PJA, in its sole discretion, deems unmarketable or otherwise inappropriate.

Item Information

Item Name:*

Estimated Value $:*

Item Description:*

Item Expiration Date and Restrictions:

I am a(n):*

Individual Donor

Business Donor

I would like to remain anonymous:*

Yes

No

Contact Information

Company:*

First Name:*

Middle Name:

Last Name:*

At least one phone number is required.*

Mobile Phone:

Home Phone:

Work Phone:

Email:*