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AUCTION ITEM DONATION

The SIH Foundation will be hosting a silent and live auction at the gala. If you are interested in donating an item, we would be most appreciative. Please fill out the information below.

Thank you for your generous donation and your support of Southern Illinois Healthcare and the SIH Foundation.

Auction Item Donation

Item Information

Item Name:*

Estimated Value $:*

Item Description:*

Notes:

I am a(n):*

Individual Donor

Business Donor

I would like to remain anonymous:*

Yes

Contact Information

Company:*

First Name:*

Middle Name:

Last Name:*

Address:*

Address2:

City:*

State:*

Postal Code:*

Country / Location:*

At least one phone number is required.*

Mobile Phone:

Home Phone:

Work Phone:

Email:*

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Auction Item Donation

Thank you to our Corporate, Diamond, Beverage, Entertainment & Ruby Sponsors!