Ozark Chapter of the Sierra Club
15th Annual Campout & Reunion

September 7-9, 2001 at Cuivre River State Park

SILENT AUCTION DONATION FORM

PLEASE PRINT OR TYPE YOUR RESPONSES:
I WILL DONATE THE FOLLOWING ITEM(S): __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

COMPLETE DESCRIPTION (Please be specific; include times, dates and restrictions on use): ______________________________________________________________________________
____________________________________________________________________________________________________________________________________________________________

ESTIMATED RETAIL VALUE: $_____

Sierra Club will auction: ogift certficate o item o service

Donor name to be listed on silent auction bid sheet: ____________________________________

Donor [signature of person with legal authority to donate item(s)]: ________________________

Donor Address [for thank you note]: ________________________________________________

Donor City: ____________________________________ State: _______ ZIP: ______________

Donor Phone: _____________________________

Local Solicitor & Phone: _______________________________________________

WE GRATEFULLY ACKNOWLEDGE YOUR DONATION!

Please complete and return this form by September 4, 2001:
Sierra Club, Ozark Chapter The local Sierra Club member who solicited
1007 North College, Suite 1 your donation will follow-up with you
Columbia, MO 65201 regarding picking up your donation.
Phone: (573)815-9250 Fax: (573)442-7051

Please note that the proceeds of the Silent Auction help support our

environmental and legislative work so donated items are not tax-deductible.