Foundation > Park Nicollet Health Services

Donate auction items

Your support for the Celebration for Life Gala makes a significant difference in the lives of those we serve. The 2009 gala will support the Healthy Community Fund of Park Nicollet Foundation, providing programs and services for those we live and work with every day.

	Donate an auction item! Identical items: list on one form. Different items: list on separate forms.   (*required field)     * Donor name (as you want it to appear in the program)     Who is donating the item(s)? (select one) Individual    Company    Park Nicollet department   * Contact name   * E-mail address   * Phone (example: 555-555-5555)   * Street address 1 (for acknowledgment)   Street address 2   * City   * State ALABAMA ARKANSAS ARIZONA CALIFORNIA COLORADO CONNECTICUT DIST. COLUMBIA DELAWARE FLORIDA GEORGIA IOWA IDAHO ILLINOIS INDIANA KANSAS KENTUCKY LOUISIANA MASSACHUSETTS MARYLAND MAINE MICHIGAN MINNESOTA MISSOURI MISSISSIPPI MONTANA NORTH CAROLINA NORTH DAKOTA NEBRASKA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEVADA NEW YORK OHIO OKLAHOMA OREGON PENNSYLVANIA RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VIRGINIA VERMONT WASHINGTON WISCONSIN WEST VIRGINIA WYOMING   * ZIP code   * Quantity   * Detailed description Please be specific (include more than "painting" or "antique lamp"). Description will go in the auction book.   * Value   * Restrictions (days of week, dates to be used [timeshares], taxes, exclusions, etc. Enter N/A if not applicable)   * Certificates valid through:(preferred expiration date Oct. 4, 2010. Enter N/A if not applicable)   (please select one) I will mail a gift certificate(s) for the auction item(s) by (enter date) to: Park Nicollet Foundation 6500 Excelsior Blvd. St. Louis Park, MN 55426 I request Park Nicollet Foundation to prepare a certificate(s) that instructs the purchaser(s) to contact me directly. I will deliver the auction item(s) by (enter date) to: Park Nicollet Foundation 6500 Excelsior Blvd. St. Louis Park, MN 55426 I cannot deliver the auction item(s). Please have a Foundation representative contact me to arrange pickup.