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Henig Charity Auction Program Information Form

Thank you for your interest in our Charity Auction Program. We look forward to working with you to establish a proven money making program for your organization. Please provide the following information (mandatory information is indicated with a *) and we will contact you as soon as possible. You must provide your Federal and State Charitable Organization Tax ID Numbers to participate in this program.


Contact Name*

Charitible Organization Federal Tax ID Number*

Charitible Organization State Tax ID Number*

Charity or Organization*

Street Address

City
State:        Zip:

Telephone, including area code

Fax number, including area code

E-mail Address*

Date of Event
Type of Auction

Silent

High Bid

Other (specify in other comments below)
Please indicate any other comments: