|
Personal Information
|
| Name: |
| Address: |
| City ___________________State_____ Zip________ |
| Daytime Telephone: |
| Shipping Address: |
| City ___________________State_____ Zip________ |
| Non Auction Item
Purchase |
| Lot# ________Title_________________________________________________
Purchase Amount $_____ |
| Lot# ________Title_________________________________________________
Purchase Amount $_____ |
| Lot# ________Title_________________________________________________
Purchase Amount $_____ |
| Lot# ________Title_________________________________________________
Purchase Amount $_____ |
Please add 10% of the cost of the artwork if shipping
& handling is needed. Shipping $
|
Please refer to the artists listing in the catalog
for Lot numbers as well as works and prices.
|
| Live Auction
absentee bid |
| Lot# ________Title________________________________________________
Maximum Bid Amount $ |
| Lot# ________Title________________________________________________
Maximum Bid Amount $ |
| Lot# ________Title________________________________________________
Maximum Bid Amount $ |
| Lot# ________Title________________________________________________
Maximum Bid Amount $ |
Please add 10% of the cost of the artwork if shipping
& handling is needed. Shipping $
|
Please refer to the artists listing in the catalog
for Lot numbers as well as works and prices.
|
Fund-A-need Donaton |
| $50____ $100______ $250________ Other
$__________ |
| Billing Information |
| Check Enclosed Amount $_______ VISA______
Mastercard_______ |
| Card # _______________________________________________Expiration
Date____________ |
| Signature: |
|
Mail or fax form to:
Spirit 2002/MONA
2401 Central Avenue Kearney, Nebraska 68847
Phone (308) 865-8559 Fax (308) 865-8104
Web: monet.unk.edu/mona
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|
If Nebraska resident, add state rate
of 5% and your local sales tax. No tax if shipping out of state. |
|
Subtotal
Tax
Fund - A - Need Donation
Total |