Beth Israel Deaconess Hospital - Needham Annual Gala : Beth Israel Deaconess

Auction Item Acquisiton Form

Please fill out the form below if you would like to donate a silent or live auction item to BID-Needham's annual Gala on November 6, 2009 at the Newton-Marriott Hotel to support the South Wing Expansion.
If you have any questions about the auction of Gala, please contact:

Meredith Giannotti
Phone: (617) 667-7368
aauciell@bidmc.harvard.edu

Please mail items to:
Office of Development
Beth Israel Deaconess Hospital-Needham
300 Brookline Avneue (BR)
Boston, MA 02215

*1. Question - Required - Item Name:

2. Question - Not Required - Description of gift item or service:

*3. Question - Required - Estimated value (for tax purposes)

4. Question - Not Required - Acknowledgement should be sent to (if other than donor please provide name and address):

*5.

Question - Required - Please submit all items to the Office of Development. I will drop off the donation
I will mail the donation

6. Please enter your information:

*

Name:

First Required

Last Required

*

Email: Required

*

Street 1: Required

Street 2:

*

City/State/ZIP:

City Required

State Required

ZIP Required

*

Phone Number: Required

Yes, I would like to receive e-mail from Beth Israel Deaconess Medical Center

Yes, I would like to receive postal mail from Beth Israel Deaconess Medical Center

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