Jubilee REACH
First Name (REQUIRED)
Last Name (REQUIRED
Address
City
State Zip
Daytime Phone
Email (REQUIRED)
Repeat Email (REQUIRED for verification)
MENU (choice of) Filet Mignon, Halibut Filet, or Artichoke Spinach RavioliMake selection below.
This portion pertains to BRC members only!
SPOUSE/PARTNER/GUEST INFORMATION
All BRC members will automatically be billed for 2 auction tickets on their Rotary accounts. The name and meal selection provided in the area directly below apply to those 2 tickets.
Enter the name of your spouse, partner, or personal guest who will be accompanying you to the auction, using one of the 2 tickets for which you are automatically billed. Do not enter this person's name in the Guest Information area.
Select two dinner entrées below, one FOR YOURSELF and one FOR YOUR SPOUSE/PARTNER/GUEST. Enter the number in the appropriate box(es) next to your choice(s).
Filet Mignon Halibut Filet Ravioli
TICKETS
I wish to support the Bellevue Rotary Foundation with the purchase* of (an) auction ticket(s) ($175 per person/ticket).
IMPORTANT: All BRC members will automatically be billed for 2 auction tickets on your Rotary account! Do NOT include those 2 tickets in the number you enter in this field. This number is only for additional guest tickets.
Be sure to scroll down and complete guest information and both member and guest dinner selections.
DONATION
I am unable to attend, however I am making a tax-deductible contribution to the Bellevue Rotary Foundation.
TOTAL AMOUNT (tickets or donation): $
If you are making a donation only and are not attending the auction, click here to go directly to the payment information.
TABLE INFORMATION
GUEST INFORMATION
The following fields are for the names and address information for guests who are NOT BRC members.
GUEST #1 - Name
Please select one dinner entrée for each guest and enter the number in the appropriate box next to choice(s).
GUEST #2 - Name
GUEST #3 - Name
GUEST #4 - Name
PAYMENT METHOD
PLEASE READ: If you get an error page after you submit this form, it means your form has NOT been submitted. You should use your browser's back button and make sure you have entered your name and email address (required fields) and submit the form again. If you have questions about this form, please contact the web flunky.
For more information contact Sue Albrecht, Auction Coordinator.
*The “Fair Market Value” of this event is $68.00 per person.
DELETE THE TEXT IN THE FIELD BELOWThis is a spam protection measure. The field above must be empty or the form cannot be processed. Highlight the prefilled text and delete it or use your backspace key.
If you are a Bellevue Rotary member and are unable to use your two tickets, please enter your name below and click Submit to let the Auction Committee know your tickets can be donated.
NAME