2009 Auction Donation Form - V3 (1)

The Emerson School Date: ___________________________________

2009 Auction Donation Form Procured by: _________________________________

Name of Donor/Business: _________________________________________________________________ Contact name/Title: ______________________________________________________________________ Address: ______________________________________________________________________________ Street

city

state

zip

Phone: ___________________________________ Email: _______________________________________ Description of item(s) donated: _____________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ Suggested retail value: ___________________________________________________________________ Special conditions (exp. Dates, invalid dates, etc.): _____________________________________________ ______________________________________________________________________________________ Please check one of the circles below:

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Gift certificate enclosed The Emerson School, please make a gift certificate for amount described above Merchandise or gift certificate must be picked up at address above by: ________________ Donor will deliver merchandise to The Emerson School on: _______________

Signature of donor: _______________________________________________________ Check here if you would like to be contacted about advertising in the auction program. Check here if you would like to be invited to attend the Emerson School auction on 11/14/09. Return this portion to your auction contact, to the Emerson School, or fax to 503-223-4875.

The Emerson School 105 NW Park Ave. Portland OR 97209 ph: 503-525-6124 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - detach here - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

The Emerson School 2009 Auction Donor Receipt

Tax ID # 52-2368753

Name of Donor/Business: _________________________________________________________________ Description of item(s) donated: _____________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ Suggested retail value: ___________________________________________________________________ Thank you very much for your donation! Investing in education pays long-term dividends, and we appreciate your willingness to help.

The Emerson School 105 NW Park Ave. Portland OR 97209 ph: 503-525-6124