2025 Leukemia Ball - Auction Item Donation Form

Donor Information:
Please provide the information of the company/family/individual donating the item(s) below

Donated courtesy of: *

Individual name or company that will be listed on the Mobile Bidding Website.

Donor Address: *

Address Line 2:

City: *

State: *

If International, Province or Country:

Zip / Postal Code: *

Donor Phone: *

Donor Email: *

Are you the Donor? *

Yes

No

Contact Information:
Please provide your contact information as solicitor or item requestor

First Name: *

Last Name: *

Phone Number: *

Email Address: *

Item Information:

Description of item(s) for display (in 40 words or less*):
Please include specific details i.e. number of people, specific location; if house/condo, number of bedrooms/bathrooms, etc.
Links to business/property are great, and additional space below if needed! *

*Due to space constraints within our electronic bidding system, edits may be made to description

Additional Item Information (if needed for description/redemption):

Who should be contacted for item redemption? *

Contact Donor

Other (Please enter contact information below):

Full Name: *

Phone Number: *

Email Address: *

Value of Item: *

Required For IRS Purposes

Do you have a preference for item display? (i.e. how you would like your item presented at auction) *

Yes

No

Donation Restrictions:
Please list any restrictions for your donation here. These include: available booking times, blackout dates, timing for winner to redeem, how to redeem, etc. This is the perfect place to add any notes for the auction manager about item/experience specifics you would like added into display sheet! *

Donation Details:

Expiration Date: +

Gratuity: *

Included

Not Included

Tax: *

Included

Not Included

Certificate: *

Provided By Donor (uploaded to form above)

Please Create a Certificate for Item

Item(s) can be packaged with other items *

Yes

No

Please upload any certificates, photographs or documentation of the item(s) to display at auction:
Accepted file types are: avi, bmp, doc, docx, gif, jpeg, jpg, webp, heic, mp3, mp4, mpeg, mpg, pdf, png, ppt, pptx, txt, wav, wmv, xls, xlsx, zip
*

How did you hear about the Leukemia Ball silent auction? *

Who were you referred by?

Please submit items and donation forms by March 7, 2025

Delivery Information:

If unable to email or digitally deliver donation, please coordinate mailing your item with:

Katie Stegman- Campaign Development Manager

LLS Mid-Atlantic | 344 Maple Avenue #227, Vienna, VA 22180

If you have any additional questions, please contact Katie at 443-471-1613 or katie.stegman@lls.org

LLS is a 501(c)3 non-profit organization. Tax ID 13-5644916

LLS RESERVES THE OPTION TO USE AUCTION ITEMS IN OTHER LLS AUCTIONS AS DEEMED NECESSARY