Starlight Auction Item Donation Form "*" indicates required fields Donor InformationWhat type of donation would you like to make?*—Cash donationGift or Basket DonationI'd like to purchase an item off the Amazon Gift RegistryDonation Amount* $25.00 $50.00 $75.00 $100.00 Other Your Donation Amount* Credit CardCard Details Cardholder Name Total Name* First Last Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail* Item Donation InformationItem Name*Item Value*Item Description (For Use in Auction Program)*Item Delivery Method Drop off / Mail to SABAH Have your item picked up by SABAH Drop off / Mailing Address: SABAH 2607 Niagara St. Buffalo, NY 14207 Phone – 716-362-9600 Fax – 716-362-9601 Email – SA***@******NC.ORGIs the item location / contact information different than the donor information? No Yes Name First Last Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail Donor Tax Information– In compliance with IRS requirements, we inform you that SABAH has not provided you with any goods or services in consideration for your gift. – Donations become the property of SABAH. – Valuation of donated property is responsibility of donor.I agree to the Terms and Conditions* I agree
