Auction Participation Form


Great TV Auction

Company Name:

  

Item Script: Please tell us about your item or certificate in the space below:

Contact Name:

Address:

City, State ZIP:

 ,

Phone:

FAX:

E-Mail:

Web Site:

Item:

Please tell us about any limitations for the item:

Questions?

Auction & Special Events Office
Phone 570-602-1121

Email:


Quantity:

Value (each):

Expiration Date (if any):

If the item is a certificate, would you like us to print it for you?

Yes No, I'll provide my own
N.R.

Do you need a pick-up of the item?

Yes No