Pasto Agricultural Museum Annual Silent Auction

Auction Donor Form (Only one donor per card)

Instructions

  1. Complete this form online
  2. Print a hard copy of the form and and sign it
  3. Submit this form to notify the Pasto Museum of your donation.
  4. Include the hard copy of the form with delivery of donated item(s).

Deadline: July 24, 2009

** All Fields Required **

Name of Event
Penn State Pasto Agricultural Museum Silent Auction
Donor Name
Company Name
If company, title or relationship to company.
Address
City
State
ZIP
Telephone
E-mail
Date of Donation
Description and value of gift(s)
Disclaimer

No goods or services were provided to the donor by The Pennsylvania State University. The University cannot accept gifts of services as gifts in kind.

Donor Signature

Date

For Official Use Only

Signature of Person Accepting Gift

Date

** Confirmation will be made within 72 hours. If you do not recieve a confirmation message within the 72 hours, please contact the Pasto Agricultural Museum Office by e-mail, phone: 814-863-1383, or
fax: 814-865-3103.

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Contact, questions or comments:pastoagmuseum@psu.edu
Last modified Thursday, July 23, 2009 13:16