Donor

Donor/Contact Name:

Email address:

Name to be Listed in Program

Business Name:

Street Address:

City State Zip:

Business Phone Number:

Item

Item:

Item Description:

Please give details, i.e., quantity, size, color, etc.

Donation Restrictions:

Pick Up Instructions:

Approximate Value:

Gift Certificate:

Donor to provide Lake Oswego Rotary to provide

Merchandise:

Donor to deliver Lake Oswego Rotary will pick up

Pick Up/Delivery Date:

Item Solicited By:

(Name of Rotarian)

Note: Unless otherwise specified, all donations of items
and services will be valid for one year from date of auction.