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Silent Auction Donation Form
The Blackstone Chamber of Commerce
Office Location: 105 West Broad Street, Blackstone, VA 23824
PO Box 295,
Blackstone, VA 23824
Email: blackstonevachamber@gmail.com
Phone: (434) 294-0280
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Email
*
Your email
Name (Last, First)
*
Your answer
Name of Business or Organization
*
Your answer
Address
Your answer
Best Contact Email
*
Your answer
Contact Phone Number
*
Your answer
What is the good or service that you will be donating?
*
Your answer
What is the estimated value of the good or service that you will be donating?
*
Your answer
Signature
*
By typing your name below you are offering a good or service to The Blackstone Chamber of Commerce at no charge to be used in the Silent Auction.
Your answer
Date of Signature
MM
/
DD
/
YYYY
A copy of your responses will be emailed to the address you provided.
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