Prize and Goodie Bag donations


	Donations subject to final approval.


	Minimum value for Goodie Bag Items (all attendees) is $5 and for all prizes is $10

*Full Name:

Please enter your first and last name

Company Name:

Enter your Company name if applicable

*Address:

Enter your full street address

*City:

Enter your City

State:

Enter your State or skip to Province field for Canada

Province:

Enter your province if a Canadian donator

Zip Code:

Enter your US Zip Code

Non US postal code:

If you are not in the US please use this field to enter your postal code

*Country:

Choose your Country

*Phone Number:

- - x

Enter your phone number

Website Address:

Enter the website address you would like to have linked to from our prize donors page

*Email Address:

Enter your email address

*Donation Type:

Virtual Download

Physical Item

Other:

Is your donation a virtual download item or a physical item that you will actually be mailing out to the winner?

Virtual Download:

All Attendees

One Winner

Other:

*Donation Description:

(chars left: 1000)

Describe in detail the exact prize/goodie bag item you are donating

*Value:

$	Enter the value of your donation (per item EX: if you are donating a wrapper set for 10 winners and the value for the download is $10 then list just $10 not $100)

Virtual File:

If your donation is a virtual file, please upload it here. When you click on browse it will open a file find box for your local computer. Find the file and click insert/open and you will be brought back to your form. then click the upload button to actually upload the file. If your file has multiple items within it (EX: Wrapper Set) please zip up the file into one file and upload that zipped file.

*Image Verification:

Enter the code above.

Enter the verification code exactly as shown