* Name:  _____________________________________________________________

Address: _____________________________________________________________

City:    ________________________________ Zip: _______________________

* Phone: ________________________________ Email: _____________________
         
* Title: _____________________________________________________________
         

* Description:  (Use description from last year's catalog? ___)

         _____________________________________________________________

         _____________________________________________________________

         _____________________________________________________________

         _____________________________________________________________

* Type of    Artwork      China/Glass   Collectible       Dinner
Item :     
            Education    Entertainment   Excursion      Fellowship 
(Circle                                                 Activities
 one)         Food         Jewelry     Miscellaneous
                                                         Services
             Tickets    Vacation/Lodging

Est Value (optional) :    _________   Min Bid (optional) : ___________

                                      Fixed Price Y/N    : ____
Qty (#items, places at 
  dinner, lots...etc.) :  _________   Date & time :        ___________

Other Comments for us
 specific to this item : ____________________________________________

Would you like to volunteer on auction night? ____

Can you bring a donation to the bake sale?    ____ buffet? ____

Additional notes: