**Solicitor     

**Donated by

    Address      

**City            

    State           

    Zip Code    

    Phone number

**Contact person

**Complete Description

**Value      $ 

**Is Item a Certificate?   Yes    No

    If yes, does certificate need to be created by the chamber?   Yes      No

**Where is item stored

**Does item need to be picked up?   Yes     No

If yes, where and when

Special instructions