Donate an Auction Item

Fields marked * require an entry.

Untitled Document

Donate an item to our Gala auction! Please note that medical services, cosmetic procedures, diabetes management tools, and items on consignment are 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 us at 585-546-1390.

Thank you for your support!

Item Information

Item Name:*

Estimated Value $:*

Item Description:*

Notes/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:*