Your browser does not have JavaScript enabled.
You will need to enable JavaScript before you can use this webpage.

Search for help on enabling JavaScript

Hearts of Gold
Auction Preview
Tickets
Sponsorship
Procurement Form

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:*

*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

Additional Information/Item Restrictions:

I am a(n):*

Individual Donor

Business Donor

*Please enter a value

I would like to remain anonymous:*

Yes

No

*Please enter a value

Item Type:

Gift Certificate

Merchandise

Services

If Gift Certificate:

Included with Form

Donor will Send

Rotary to Generate

Item Category:

Procured By (Solicitor/Rotary Member):

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:

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.

Submit
Reset

Processing, Please Wait...

Doors open at 5 pm

Share

Thank you to our wonderful sponsors

Powered By Greater Giving

Terms of Use
Privacy Statement