Auction Item Donation Form

Please Mail Auction Items as Follows:

Certificates:
Addi and Cassi Fund
c/o Ancora West
PO Box 19427
Reno, NV 89511

Larger Gifts:
Addi and Cassi Fund
c/o Ancora West
8630 Technology Way
Reno, NV 89511

Please Use the Following Form to Donate an Auction Item...

Item Information

Estimated Value $:*

Item Description:*

Notes:

I am a(n):*

Individual Donor
Business Donor

I would like to remain anonymous:*

YesNo

Item Name:*

Contact Information

Company:*

First Name:*

Middle Name:

Last Name:*

Address:*

Address2:

City:*

State:*

Postal Code:*

Country:*

At least one phone number is required.*

Mobile Phone:

Home Phone:

Email:*

Fields marked * require an entry.

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