ASLMS Home Page
ASLMS Silent Auction Item Submission Form
   
First Name:
Last Name:
E-mail:      
Company Name:
Address:
City:
State/Province: Postal/Zip Code:
Country: Company Web Site:
Phone: Fax:
Auction Category:
   
Item Title:
   
Donated By:
Item Description:
Item Description (continued):
Estimated Value:
Preferred Financier:
Bidder Qualifications:              PHYSICIANS ONLY     None
 
Please Include Specific Constraints/Conditions for Qualified Bidder (if applicable):
Installation and Training Information (if applicable):
Warranty:
   
For More Information Visit (web site URL and/or e-mail):  You can supply an address for bidders to research or contact you.
Additional Comments:
Images - Please submit up to three images and your company logo for inclusion with the auction item.  Images should be under .5 megabyte and in any of the following formats: jpg, png, bmp, tiff or gif.  If you have difficulties submitting the images using this form, you can e-mail them: here.
   
Logo: Please select your company logo (from your local hard drive or network) to be included with this item.  
   
Item Photo 1:  
   
Item Photo 2:  
   
Item Photo 3:  
   
Item Flyer (if available): PDF files may also be included with the auction, but will appear as links.  This may be useful if you have a product flyer for the auction item.  
   
   
I have read and agree to the ASLMS COMMERCIAL SUPPORT GUIDELINES & CONDITIONS.

Donations made to the ASLMS Silent Auction are tax deductible. If you are donating an item you may deduct the value of the item you are donating. If you are bidding on an item, you can only take a charitable tax deduction if the bid you make is more than the value of the item.  The deduction would equal the difference between the value of the item and your bid. The consumer of the property may be subject to use tax in their specific state depending on the state's use tax filing requirements and exemption provisions.

Foreign Donations: Donations made to the ASLMS Silent Auction are not tax deductible in your country, however if you have any U.S. income, you may be allowed a deduction against that U.S. income.

The Sponsor agrees to abide by all requirements of the ASLMS Commercial Guidelines. The Society further agrees upon request to furnish the Sponsor a report concerning the expenditure of any funds provided. The ASLMS will control content and select presenters and moderators. We agree not to direct course or conference content.

Agree                 Disagree 

Electronic Signature:                

The auction will start 3/1/08 and end 4/2/08 11:59 CST. The auction will resume at 5:30 PM CST 4/3/08 thru 7:00 PM 4/5/08.  You will be notified when we receive your submission.  Questions about the status of your auction item should be directed to: jane@aslms.org.
Depending on the size of images and your connection speed, this form can take several minutes to submit. 

Please Do Not Press Send More Than Once.

Some visitors have experienced trouble submitting the donation form.  Please contact the central office to ensure that your form has been received at 715-845-9283.