Survey

Thank you for donating to The Channel 10 Auction. Please complete and click on submit. An auction staff person will contact you to confirm the details of your donation. Thank you for supporting Milwaukee Public Television!

If you have any questions please contact us at #262.781.4998.

1. I am donating

I am donating Merchandise

Certificate(s)

2. Item Title

Item Title

3. Value of item

Value of item

4. How many are you donating?

How many are you donating?

5. I would like to remain anonymous.

I would like to remain anonymous. Yes

6. Donated by (this will be read on-air)

Donated by (this will be read on-air)

7. City

City

8. Description of Item

Description of Item

9. If I am donating certificate(s), I would like to

If I am donating certificate(s), I would like to submit my own certificates (please mail them to the Auction Office in Brookfield).

have the auction staff create certificates for me.

If you are mailing in your certificates please mail them to:

The Channel 10 Auction

12560 W. Townsend St.

Brookfield, WI 53005

10. Expiration Date (for certificates)

Expiration Date (for certificates)

11. Restrictions (if any)

Restrictions (if any)

12. Donor Contact Information

Donor Contact Information Business
Contact Person
Address
City
State
Zip
Phone
Fax
Email
Website

This donation becomes property of MPTV Friends, and is to be offered for sale at an Auction, the proceeds of which to to WMVS/WMVT-TV. The item value is provided by the donor.

13. Please type your name to electronically sign this donation form. Thank you for your support.

Please type your name to electronically sign this donation form. Thank you for your support.