Auction Item Donation Form

First Name

Last Name

Mobile Phone

Donor Type

Company/Organization Name

Street Address

City

State

Zip Code

Please fill out this section for each item donated

Type of Donation

Detailed Description (Please include detailed description of your donation.)

Restrictions, If Any (e.g., Expiration date(s) of item, terms of use, etc.)

Note: Service must be available for use within a year, unless otherwise specified.

Estimated Fair Market Value of Individual Item

Delivery Date or Date When Opportunity Will Be Provided

Please use two digit month and day, and a four digit year.

**Items must be donated by March 13th, 2024 or Dragonfly reserves the right to use the item(s) at a future Dragonfly event.

To make a monetary donation, please visit Dragonfly.org

Delivery Information (Select One Option)

I will mail or drop off my donation to DragonflyDragonfly must pick up the itemI have already provided a Dragonfly Representative with the donation

Thank you for your support!

513/494-6474

For more information visit: dragonfly.org/gala

The Dragonfly Foundation is a 501(c)(3) non-profit organization dedicated to helping pediatric cancer patients (birth to age 40) and their families find strength, courage, and joy. Donations to The Dragonfly Foundation, a qualified organization under IRS regulations, are deductible as allowable by law. All donations will be acknowledged in writing with Dragonfly's tax identification number. Please contact your tax advisor for advice concerning the deductibility of your donation.

The Dragonfly Foundation | 506 Oak Street | Cincinnati, OH 45219