Cure for Mito Auction Procurement Form

Thank you for donating items to the Mitochondrial Research Guild Auction. We will accept donation commitments for this year's auction until August 30th. Please use this form to provide information about the donation. Fill out the form and use the Verify button below. Then, you must then press the Save button on the next form after checking the information you entered.

Donor Information

Donor Name/Company (* - Required)

Donor Address

Street *

City *
State *	Zip *

Donor Phone *

Donor Email Address

Donation Details

Donor Name for Catalog *

Title for Catalog *

Description for Catalog *

Restrictions (if any)

Value *

(US Dollar)

Donation Handling *

Item/Certificate will be sent to address below.

Item will be ready to pick up after date(dd/mm/yyyy).

The guild must create a Certificate.

Donations for Sponsorship or Catalog Advertising By making a cash donation, you can become an Auction Sponsor or get advertising placed in the auction catalog for your organization. To find out more about being a sponsor and the various donation levels please examine this PDF document.

Sponsorship/Advertisment Donation Amount

(US Dollar)

Process Donation

Mail Checks, Certificates or Items by August 1st to:

The Mitochondrial Research Guild
PO Box 761
Lynnwood, WA 98046

Or,

Email to j.herczog@verizon.net
Fax # 425-744-2895
Phone # 425-670-3343

For additional information on how you can help please contact Jill Herczog at j.herczog@nwmito-research.org or Ashley Farrington at a.farrington@nwmito-research.org.

Facebook Mito Group

2010 Mito Guild Calendar

Saturday
September 11
The 8th Annual Cure for Mito Auction

In Loving Memory...

Justin Brubaker 1997-2009
Mariah Turner 1995-2009
Donald Dee Neuert

Click name for PDF Document