Donation Submission

Next NHPTV Auction: May 1 - 10, 2009
To receive on-air promotion during the live TV Auction just complete and submit this form.
If you have any questions about donating or volunteering, please email us at or call the Auction office at (603) 868-4432.

* - required fields

Company:
First Name:	*
Last Name:	*
Address:	*
City:	*
State:	*
Zip:	*
Phone:	- - * Ext.
FAX:	- -
Email:	*
Website:	*
Donation:	*
Retail Value:	*
CERTIFICATE DONATIONS
I'll provide my own certificate: Yes No Please mail to: NHPTV Auction 268 Mast Rd. Durham, NH 03824
High bidder is asked to use Certificate by:
Exchangeable?	Yes No N/A
Installation Included?	Yes No N/A
Service radius? (i.e. 50 mile radius of Durham)
Description for on air script:
Limitations, Blackout Dates, Special Features
NON-CERTIFICATE DONATIONS
Description for on-air script:
Exchangeable?	Yes No N/A
I can ship or deliver my donation: NHPTV Auction 268 Mast Road Durham, NH 03824	Yes No

Donation Submission

CERTIFICATE DONATIONS

NON-CERTIFICATE DONATIONS