2019 LJS&C Gala Auction Donation Form Name Donor Information First Name * Last Name * Street Address * Apartment/Unit # City * Zip Code * State * - Select Province/State - Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ==================== Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Email Address * Phone Number * Auction Donation Information Please describe in detail, including any special features, limitations, etc. If a gift certificate, note that our event takes place on Saturday, September 28, 2019, and gift certificates should start after that date and be good for at least one year, if possible. Restrictions: Blackout dates: From: To: Expiration Date: Contributions are at the fair market value you establish. Please do not state “priceless” as the item value. A receipt for donations will be mailed upon receipt of the item. Value in USD ($): * Donation Delivery: * Will Mail to LJS&C Will Bring to LJS&C office Will Email I require a pick up Please attach brochures, pictures or other items for auction display. Fax this form to 858-534-9947 or email to firstname.lastname@example.org or mail to: LJS&C, 9500 Gilman Dr., UCSD 0361, La Jolla, CA 92093-0361 For more information, call 858.534.4637 or email email@example.com. Deadline for Program Inclusion: September 10, 2019 Thank you so much for your auction donation! Greatly Appreciated! LA JOLLA SYMPHONY AND CHORUS IS A 501(C)3 NONPROFIT SERVICE ORGANIZATION. TAX ID# 95-1962652.