EmailMe Form - AVCA Silent Auction Donation Form

Contact Name: *

First Last

School/Organization/Company: *

Address: *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Phone Number: *

### - ### - ####

E-mail: *

Web Site:

Short Description of Item(s) (Title): *

Long Description: *

Picture(s) of Item(s):

Retail Value of the Item(s): *

Product/Value, Product/Value

Please choose one of the following: *

I will bring the auction item to AVCA Convention in Columbus on Dec. 15th or 16th

I will ship my auction item to AVCA Headquarters by November 13th

I plan to ship my auction item directly to the winning bidder

Signature *

I acknowledge that by submitting and signing this form that I have read the AVCA Auction Guidelines and will abide by the requirements set therein.