Concert for the Planet Auction Donor Form PhoneThis field is for validation purposes and should be left unchanged.Name* First Last Please add your nameAddress* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Contact Number*Email* Item Name*Estimated Value $*Item Description*Please include any restrictions or expiration dates. If trip, please list the length of trip and number of guests.NotesItem Delivery or Pickup must be scheduled by October 15, 2026.* I will deliver the item to the CPF Office Please have Captain Planet staff contact me to arrange pickup Please choose from these options:Please tell us what date we can expect delivery of your donation.* MM slash DD slash YYYY If we are picking the item up, what date will it be ready to pickup?If there will be no physical item, please choose one of the following options:* I am emailing a Certificate for the winner to lauren@captainplanetfdn.org Captain Planet Foundation needs to create a Certificate for me Please upload 1-3 high-res photos of the item and company logo as part of completing this form Drop files here or Select files Max. file size: 128 MB. Add a video url OptionalAgreement to Donate* By checking this box I acknowledge that I am making a donation of the above said item(s) to the Captain Planet Foundation. Δ