THE TICKET ITEM DONATION

Fields marked * require an entry.

SUPER TICKET DRAWING

ITEM DONATION FORM

Super Ticket items will displayed at the EVENT 2013. Actual Super Ticket Drawing will take place the week after THE EVENT 2013.

Item Information

Item Name:*

Estimated Value $:*

Item Description:*

Notes:

I am a(n):*

Individual Donor

Business Donor

I would like to remain anonymous:*

Yes

No

Solicitor Name?

Contact Information

Company:*

First Name:*

Middle Name:

Last Name:*

At least one phone number is required.*

Mobile Phone:

Home Phone:

Work Phone:

Email:*