Gala Auction Donation Form – Delta Hospital and Community Health Foundation

Donated Courtesy Of: *Individual, Business, or Family that will be listed on the online auction website.

Donor Prefix

Donor First Name

Donor Last Name

Donor Address: *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Donor Email Address *

Donor Phone

Donor Website

Is the Donor the Primary Contact? *YesNo

Primary Contact Name *Please enter Primary Contact information below

Primary Contact Email Address

Primary Contact Phone

Item Description:Please provide a detailed description of the item, includig any relevant features, specifications, or important information for display.

Item Restrictions:Please list any restrictions for your donation here. These include: available booking times, blackout dates, timing for winner to redeem, how to redeem, etc. This is the perfect place to add any notes for the auction manager about item/experience specifics you would like added into display sheet.

Please upload any certificates, photographs or documentation of the item(s) to display at auctionAccepted file types are: avi, bmp, doc, docx, gif, jpeg, jpg, webp, heic, mp3, mp4, mpeg, mpg, pdf, png, ppt, pptx, txt, wav, wmv, xls, xlsx, zip

Who should be contacted for item redemption?DonorPrimary ContactOther (Please enter contact information below)

Full Name

Email Address

Phone

Retail Value of Item/Experience: *Required for CRA Purposes

CAD

Upload Logo FileIf your gift is valued at $1,500 or more, please send us your high-resolution logo, preferably in vector (.ai, or .eps), by Friday, October 3rd 2025.

No file chosen

Please upload any purchase receipts for this item:If you purchased the item being donated you may be eligible to receive a charitable tax receipt for your contribution.

Delivery for Tangible ItemsI will deliver to the Foundation by Friday, October 3rd 2025.I wish to have my item picked up by the Foundation. Item will be ready on this date:Item is a certificate

Pickup Date

CertificateProvided By Donor (uploaded below)Please Create a Certificate for Item

Delivery Information:
If unable to email or digitally deliver donation, please indicate in the form above if you require your item be picked up or if you will drop it off. Items can be dropped off at the Foundation office, 5800 Mountain View Blvd. Delta, BC. Our office is inside Delta Hospital main doors to the right past the cafe, we are open Monday through Friday from 9am to 4pm.

If you have any additional questions, please contact Cristin Millman at 604-940-9695 or [email protected]

2025 Moonlight Gala – Auction Item Donation Form