Jubilee REACH
Also use this form for sponsorship selection, purchasing tickets/table, and ordering catalog ads. Complete applicable portion(s) and required fields.
Online procurement form submittals are preferred. However, if you are unable to complete the online form for some reason and need to print and fill out a procurement form by hand, please contact Auction Coordinator Sue Albrecht.
CATALOG DEADLINE: MARCH 2, 2012
You must complete and submit the form below no later than March 2, 2012, to ensure the item is featured in the auction catalog.
PLEASE COMPLETE A NEW FORM FOR EACH ITEM!
ROTARY MEMBER/AUCTION REPRESENTATIVE
First Name (REQUIRED)
Last Name (REQUIRED)
Email Address (REQUIRED)
Repeat Email Address (REQUIRED)
Daytime Phone
DONOR INFORMATION
Donor or Company NameAS IT SHOULD APPEAR IN CATALOG
Donor Contact Name (if different than above)
Donor Address
Donor City
Donor State
Donor Zip
Email Address
GIFT INFORMATION
Gift Item Name
Value (REQUIRED)
Donor estimate of fair market value
Gift Item Description
Please specify color, size, quantity, number of people, dates available, if exchangeable, if assembly required, etc.)
Gift Item Restrictions
Please specify all restrictions.
Expiration Date (MM-DD-YY)
Please check all that apply to gift item.
Tangible Item - Displayed at Auction
Intangible Item
Donor to Provide Promotional Material
Donor to Provide Gift Certificate
Auction Committee to Create Certificate
SPONSORSHIP LEVELS
Please make SPONSORSHIP SELECTION by selecting the appropriate button.
Title Sponsor - $20,000
Co-Sponsor - $10,000
Event Captain - $5,000
Hosts - $2,500
ADVERTISEMENT
Please make AD SELECTION below.
Full Page ... 6.5" Wide x 10" High ... $1,750
Half Page ... 6.5" Wide x 4.875" High ... $1,000
Quarter Page ... 3.125" Wide x 4.875" High ... $600
Business Card Size ... 3.125" Wide x 2.25" High ... $250
TOTAL AMOUNT OWED (REQUIRED)
Enter total amount owed for Sponsorship and/or Catalog Advertisement (You must enter something in this field. It cannot be left blank. If you don't owe anything, enter "0.")
$
If zero, enter "0"
PAYMENT METHOD
BILL MY ROTARY ACCOUNT
CREDIT CARD
If paying by credit card, you can pay online on the next page (payments processed through Skipjack Financial Service), or you can fax your credit card information to Auction Coordinator Sue Albrecht (Fax 888-814-5696).
CHECKIf paying by check, please make checks payable to "Bellevue Rotary Foundation" and mail to: Sue Albrecht, Auction Coordinator, PO Box 523, Bellevue, WA 98009
DELETE THE TEXT IN THE FIELD BELOW The field below must be empty or the form cannot be processed. This is a spam protection measure.
YES! Please send me an auction invitation!
Fed Tax ID: 91-1501333Your donation may be tax deductible. Please check with your tax advisor to see if you qualify.
Please make AD SELECTION below.
