Item Donations

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Item Donations
MVM VIII Registration

Fields marked * require an entry.

MVM VIII

Saturday, October 8, 2016

Item Information

Item Name:*

*Please enter a value

Estimated Value $:*

*Please enter a value
Please enter a valid decimal number as nnn.nn

Item Description:*

*Please enter a value

Notes:

I am a(n):*

Individual Donor

Business Donor

*Please enter a value

I would like to remain anonymous:*

Yes

*Please enter a value

Item to be:*

Mailed

Delivered

Picked-up

*Please enter a value

Certificates

Please prepare an auction certificate for me.:

Yes

Certificate expires on year from date of auction unless date otherwise noted here:

Please enter a date as mm/dd/yyyy

This item may be auctioned (ie. willing to donate service like massage to be purchased by 3 different winners):

Once

Twice

Three times

Contact Information

Company:*

Please enter a value for Company:

First Name:*

Please enter a value for First Name:

Middle Name:

Please enter a value for Middle Name:

Last Name:*

Please enter a value for Last Name:

Address:*

Please enter a value for Address:

Address2:

Please enter a value for Address2:

City:*

Please enter a value for City:

State:*

Province State is required for the United States

Postal Code:*

Please enter a value for Postal Code: Please enter a valid postal code.

Country / Location:*

Country is Required

At least one phone number is required.* Please enter at least one phone number

Mobile Phone:

Please enter a value for Mobile Phone: Please enter a valid phone number. Use x to denote extension

Home Phone:

Please enter a value for Home Phone: Please enter a valid phone number. Use x to denote extension

Work Phone:

Please enter a value for Work Phone: Please enter a valid phone number. Use x to denote extension

Email:*

Please enter a value for Email: Please enter a single valid Email.

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