AUCTION ITEM DONATION FORM: SHARSHERET ANNUAL NYC GALA AUCTION ITEM DONATION FORM: SHARSHERET ANNUAL NYC GALA On Tuesday, November 18th, Sharsheret will welcome 250 guests for the annual Sharsheret Gala at the Moise Safra Center on the Upper East Side. Hosted by renowned chef and cookbook author Kim Kushner, this special evening will celebrate Sharsheret’s commitment to supporting and educating women and families living with and at increased risk of breast and ovarian cancer. At the event, we will recognize top NYC Oncologist, Dr. Ruth Oratz who will receive the Maimonides Award and welcome Sharsheret Peer Supporter Leah Weinberg who will share her inspiring story. To help make the night even more meaningful, we have invited a select group of Jewish jewelry designers to contribute a signature piece to our auction. Thank you for your generous donation and participation in this celebration of women uplifting one another. ABOUT SHARSHERET: Sharsheret, Hebrew for chain, is the Jewish breast and ovarian cancer organization providing free and confidential emotional support, genetic and mental health counseling, patient navigation, financial assistance and life saving education. Please complete and submit this form as soon as possible. For more information, contact Special Events Associate Rebecca Shottland at [email protected] Name:* First Last Company NameEmail:* Phone:*Address:* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Item(s) Information:Item(s) being donated:Fair Market Value of item:Detailed Item Description (please be as specific as possible)Please upload a picture of the itemMax. file size: 128 MB. Please contact Rebecca Shottland to arrange for shipping or to coordinate a pickup of the jewelry. 201-705-1969 [email protected] Sharsheret Attn: Rebecca Shottland 1086 Teaneck Road, Suite 2G Teaneck, New Jersey 07666 Phone: 908-294-1789 E-mail: [email protected] Sharsheret is a 501(c)(3) not-for-profit organization. Donations are tax deductible to the fullest extent allowed by law.
