Fields marked * require an entry.

2016 Harvest STOMP Auction Donation Form

Item Information

Item Name:*

*Please enter a value

Estimated Value $:*

*Please enter a value
Please enter a valid decimal number as nnn.nn

Item Description:*

*Please enter a value

Notes:

I am a(n):*

Individual Donor

Business Donor

*Please enter a value

Please list the donor name you would like included in the auction lot description and event materials:

I would like to remain anonymous:*

Yes

*Please enter a value

Donation Restrictions/Expiration Date

This donation has restrictions and/or expiration date:*

Yes

*Please enter a value

Expiration Date:

Please enter a date as mm/dd/yyyy

Restrictions Detail:

Additional Costs

Please check all that apply and detail amount and description below:*

None

Cleaning

Tax/Gratuity

Set-up Fees

Other

*Please select one or more values

Additional Cost Amount:

Please enter a valid decimal number as nnn.nn

Additional Cost Description:

Lot Redemption Information

Please check all that apply:*

Gift Certificate will be mailed to NVG

NVG to pick up item from donor prior to event

Item will be mailed by donor to NVG

Item will be mailed by donor to the winning bidder after the event

Winning bidder to contact donor for redemption

*Please select one or more values

Redemption Contact Info

Please provide a contact name, phone, and email for item redemption:

Acknowledgement

I acknowledge that I have read and agree to the terms below:*

I agree to donate the item(s) as described and listed above to the Napa Valley Grapegrowers and, in the case of personal property (such as wine, etc.), I warrant that it is of merchantable quality. After the auction lot is sold, any changes or additions made to this donation shall be agreed upon between the winning bidder and auction donor directly. I agree and acknowledge that Napa Valley Grapegrowers is not responsible for the description and/or authenticity of the contents of the donated item or any damages arising from the winning bidder’s use of the auction item I have donated.

*Please select one or more values

Contact Information

Company:*

Please enter a value for Company:

First Name:*

Please enter a value for First Name:

Middle Name:

Please enter a value for Middle Name:

Last Name:*

Please enter a value for Last Name:

Address:*

Please enter a value for Address:

Address2:

Please enter a value for Address2:

City:*

Please enter a value for City:

State:*

Province State is required for the United States

Postal Code:*

Please enter a value for Postal Code: Please enter a valid postal code.

Country / Location:*

Country is Required

At least one phone number is required.* Please enter at least one phone number

Mobile Phone:

Please enter a value for Mobile Phone: Please enter a valid phone number. Use x to denote extension

Home Phone:

Please enter a value for Home Phone: Please enter a valid phone number. Use x to denote extension

Work Phone:

Please enter a value for Work Phone: Please enter a valid phone number. Use x to denote extension

Email:*

Please enter a value for Email: Please enter a single valid Email.

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2016 Harvest STOMP Auction Donation Form

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