Fields marked * require an entry.

Greetings Rotarians and Friends! In completing the form below,

Please complete the form as if you are the Item Donor.
The Donor name (business or first/last) is very important. Contact information is also important, please try to ensure we have up to date info.
Provide a complete and persuasive description of the item in the "Item Description".
The Foundation's Federal Tax ID Number is 91-1522960

Thank you! Your Escapades Committee

Procurement Form

Item Information

Item Name:*

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Estimated Value $:*

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Please enter a valid decimal number as nnn.nn

Item Description:*

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Additional Information/Item Restrictions:

I am a(n):*

Individual Donor

Business Donor

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I would like to remain anonymous:*

Yes

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Item Type:

Gift Certificate

Merchandise

Services

Certificate Type:

Included with form

Donor will send

Rotary to Generate

Item Category:

Procured By (Solicitor/Rotary Member):

Contact Information

Company:*

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First Name:*

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Middle Name:

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Last Name:*

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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:*

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Thank you to our wonderful sponsors

Green River College Foundation
Bill C Dugovich
Allyson & Carl Johnson
Laurie Leno & Paris Kimbrough
Sysco Corportion
Dino Traverso CPA
Andy Wangstad