South Shore Health

Auction Donation Form

On behalf of South Shore Health Foundation and the Moonlight & Miracles Gala Committee,
thank you for your interest in donating an item to our auction!

As South Shore Health’s largest fundraising event of the year, proceeds will benefit emergency services at South Shore Health, including our Emergency Department at South Shore Hospital, Level II Trauma Center, EMS, and our Mobile Integrated Health Program.

All donor names are proudly listed on the night of signage and in our program book (if donated by September 4, 2024).

Popular donations include but are not limited to:
- Gift cards or certificates to local businesses
- Tickets to sporting events or concerts
- Rounds of golf at public and private courses
- Hotel or vacation home stays
- Original artwork
- Autographed sports or celebrity memorabilia

We are looking for a wide variety of items and would love to include your donation in our auction.
Please complete the below form and a member of our team will be in touch shortly to confirm!

Question - Not Required - Donor or Company Name:

Contact Information

*

Name:

First Required	Last Required

*

Email: Required

*

Street 1: Required

Street 2:

*

City/State/ZIP:

City Required	State Required	ZIP Required

If you respond and have not already registered, you will receive periodic updates and communications from South Shore Health.

*

Question - Required - Please list name/company name as you wish to appear on signage and in program book:

*

Question - Required - Tell us about the auction item you want to donate:

Question - Not Required - Special instructions and/or restrictions (i.e. contact information needed to redeem items or blackout dates):

*

Question - Required - Item Est. Value $:

*

Question - Required - Authentication

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Moonlight & Miracles Gala Auction Donation Form

Auction Donation Form

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