Item Donation

Fields marked * require an entry.

Donate an item to our Gala auction!

Please note that medical services, cosmetic procedures, diabetes management tools, and items on consignment and not accepted in our auction. JDRF accepts only new and unused items. Antiques should be accompanied by an appraisal.

If you have any questions, please contact our office at 585-546-1390.

Item Information

Item Name:*

Estimated Value $:*

Item Description:*

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:*

Address:*

Address2:

City:*

State:*

Postal Code:*

Country / Location:*

At least one phone number is required.*

Mobile Phone:

Home Phone:

Email:*

2010 Hope for a Cure Gala Sponsors