Auction Acquisition Form ~ A Chocolate Affaire

							               Auction Donation Form ~ A Chocolate Affaire
               To benefit Cornucopia House Cancer Support Center on February 8, 2009


Donor Name (how you will be listed in the program) ___________________________________________
Auction Item/Service Description ________________________________________________
__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

Value $ ______________
Web site www. _________________________


NOTE: If you have flyers, business cards, etc. that you would like to have displayed on the auction table,

please include with your donation. These items will NOT be returned after the event.



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Donor information
Name and/or Business _________________________________________________________
Email ___________________________________                               Phone ________________________
Mailing address _____________________________________________________ ZIP __________

IF YOUR DONATION IS VALUED AT $500 OR MORE, YOU RECEIVE 2 COMPLIMENTARY TICKETS TO A CHOCOLATE AFFAIRE

________________________________________________________________________________________________________
Donor Signature                                                                 Date

Who contacted you about donating to A Chocolate Affaire? _____________________________


                                Email, fax, or mail completed form to:
             Joan Boone, Auction Coordinator ~ 1400 Mount Willing Rd., Efland, NC 27243
               jpboone@mindspring.com Phone: 919 516 3434 Fax: (866) 902-0953
                                         Thanks for your support!