Silent Auction Donation

Company name: ________________________________________________________

As it is to appear in promotions

Contact: ______________________________________________________________

Phone: _______________________________ Fax: ____________________________

Email: ________________________________________________________________

Mailing address: ________________________________________________________

City: _____________________________________ State: ______ Zip: _____________

Item(s) being donated and value:

_______________________________________________________ $ _____________

_______________________________________________________ $ _____________

_______________________________________________________ $ _____________

Donations are needed by January 5, 2009

I will bring my donation to the Chamber ________ Please pick-up my donation ______

Please print and complete the form. 

Mail: Carroll Co. Chamber of Commerce  P.O. Box 871  Westminster, MD 21158 or Fax: 410-876-1023

Thank you for your donation to the Silent Auction

All proceeds go to the Charles D. Schaffer Scholarship Fund.