Rotary Member/Auction Representative |
Name (REQUIRED) |
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Email Address (REQUIRED) |
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Team |
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Daytime Phone # |
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Donor Information |
Donor or Company Name |
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Donor Contact Name
(if different from above) |
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Donor Name
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AS IT SHOULD APPEAR IN CATALOG |
Donor Address
(company name, street/PO box, city, state, country, zip/postal code |
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Daytime Phone # |
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Fax Phone # |
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Email Address |
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Gift Information |
Gift Item Name |
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Value
(donor estimate of fair market value) |
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Gift Item Description
(Please specify color, size, quantity, number of people, dates available, if exchangeable, if assembly required, etc.) |
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Gift Item Restrictions
(Please specify all restrictions.) |
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Expiration Date |
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Please check all that apply to gift item.
Tangible Item - Displayed at Auction
Tangible Item - NOT Displayed at Auction
Intangible Item
Donor to Provide Promotional Material
Donor to Provide Gift Certificate
Auction Committee to Create Certificate
To Be Delivered By Donor
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Sponsorship Levels  |
Please make SPONSORSHIP SELECTION by checking the appropriate box (click here to review sponsorship details)
Title Sponsor - $25,000
Premier Sponsor - $15,000
Gold Sponsor- $5,000
Silver Sponsor - $2,500
Table for 10 - $1,750
Tickets-Single - $175 |
Advertisement |
Please make ad selection below (click here to review ad details)
Full Page Ad (6.5x11) - $1,750
Full Page Ad w/bleeds (7.5x11) - $1,750
Half Page Ad (6.5x4.875) - $1,000
Quarter Page Ad (4.875x3.125) - $600
Business Card Size (1/8th page-3.125x2.25) - $250
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Payment Method |
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BILL MY ROTARY ACCOUNT |
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CREDIT CARD 
If paying by credit card, please submit this form, then phone or fax your credit card information to Auction Coordinator Sue Albrecht, Ph 425-653-0867, Fax 425-653-0868 |
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CHECK
If paying by check, please make checks payable to "Bellevue Rotary Foundation" and mail to: Sue Albrecht, Auction Coordinator, 3 Tulalip Key, Bellevue, WA 98006 |
SPAM PROTECTION:
The field below must be empty or the form cannot be processed. Highlight the prefilled text and delete it or use your backspace key.
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YES!
Please send me an auction invitation! |
Fed Tax ID: 91-1501333
Your donation may be tax deductible. Please check with your tax advisor to see if you qualify.
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