presented by Altrusa International of Columbus, Ohio Foundation
Tax ID: 14-1939643
Please complete this form to donate auction items or become a sponsor.
Contact Information
Business/Contributor
*
Contact Name/Title
*
Address
*
City
*
State
*
Please Select
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code
*
Phone (primary)
*
Fax
*
Donated Item(s) for Auction
Please indicate what item(s) you are donating for auction:
*
estimated value:
*
Item(s) :
*
Will be mailed (see below for mailing address)
Needs to be picked up
Note
: please allow any certificates/gift cards to be valid for one year, exp. date May 6, 2018.
Donated Item(s) for Auction
Please indicate what item(s) you are donating for auction:
Type a question
*
estimated value:
*
Item(s) :
*
Will be mailed (see below for mailing address)
Needs to be picked up
E-mail
*
Note
: please allow any certificates/gift cards to be valid for one year, exp. date May 6, 2018.
Sponsorship Rates & Rewards
Sponsorship Levels
Please indicate the appropriate sponsorship level:
*
$750 Gold
$500 Silver
*
$250 Bronze
$50 General
Please indicate the appropriate ad space:
*
Full Page (8"x6.5") $150 each
Half Page (4"x3.25") $100 each
*
Quarter Page (2"x1.625") $75 each
Eighth of Page (1"x.8125") $50 each
If you would like to attach artwork/design for your ad please do so here:
*
Select File
Cancel
of
OR
*
You are unable to include artwork/design for your ad at this time (please email your design to altrusacolumbusoh@gmail.com no later than April 5, 2018 for inclusion.)
Payment Method (if applicable)
Please check one of the following:
*
Visa
MC
Discover
AMEX
Mailing check
Mailing cash
Name on credit card
*
Amount $
*
Number
*
Expiration
*
-
Month
-
Day
Year
Date
Security Code
*
Signature
*
Check amount $
*
Cash amount $
*
Submission Method
To finish hit SUBMIT below or print & mail to:
Altrusa-Spring Fling
Pat Fitzpatrick
PO Box 161
Marengo, OH 43334
You may direct any further questions to:
altrusacolumbusoh
@gmail.com
.
Submit
Should be Empty: