Auction Item Donation Form

Annual Gala Fundraiser ~ Saturday, January 12, 2019

All items MUST be received by December 20, 2019. 
It would be appreciated if all gift certificates were effective January 2019 through February 2020.


Donor/Company Name Donor Contact Name
Mailing Address Donor Telephone
Fax Donor Email
Please select one:

My information above is correct.  My information above has changed.I am new to Chabad.

Authorized Sig Date
Chabad Representative Name    
Please indicate how you would like your donation listed.
Please describe item(s) in detail, including any restrictions.
*Retail value of item(s):

 Please contact Auction Chair Alison Sherman with any questions:, or call our office 203.226.8584

Please bring or mail items by January 2, 2019 to:
Chabad of Westport | 79 Newtown Turnpike| Westport, CT 06880

*Value of item is tax-deductible to the extent permitted by law. The Chabad of Westport Tax ID# 22-3484390.

Thank you for your support!