Fields marked * require an entry.

Silent Auction items listed below must be delivered to:
Michael’s Mission Inc
c/o Michele Feirman
5 Wendy Road
Syosset, NY 11791

DELIVERY DEADLINE: MARCH 1, 2017

Thank you for your donation!

Michael’s Mission is a 501(c) (3) organization (EIN: 26-2573681). All donations are 100% tax deductible.

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:*

At least one phone number is required.*

Mobile Phone:

Home Phone:

Work Phone:

Email:*