Your browser does not have JavaScript enabled.
You will need to enable JavaScript before you can use this webpage.

Your browser does not have JavaScript enabled.
You will need to enable JavaScript before you can use this webpage.

Your browser does not have JavaScript enabled.
You will need to enable JavaScript before you can use this webpage.

Your browser does not have JavaScript enabled.
You will need to enable JavaScript before you can use this webpage.

Your browser does not have JavaScript enabled.
You will need to enable JavaScript before you can use this webpage.

Fields marked * require an entry.

Thank you for your generous auction item donation for our Night Of Strength Gala on November 3rd.

Items to be received by: October 22

If shipping, please send to:

Attn: Walking Strong

Michelle Fix

23836 Friar Street

Woodland Hills, Ca 91367

818-512-9630

AUCTION ITEM DONATION

Item Information

Item Name:*

Estimated Value $:*

Item Description:*

Item Details & 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:*

Mobile Phone:*

Email:*

OUR FIFTH ANNUAL GALA SPONSORS