Please provide the following contact information:

Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail

Please provide the following bidding information:

Lot #	DESCRIPTION	Amount $$

Credit Cards will not be used unless you do not pick up your items, or if you choose to use it as your way of paying.  Your credit card is only used as an insurance policy to guarantee payment and to provide us confirmation that you are who you say you are.
	BILLING
Credit Card #
Expiration Date	20
Account Name

	SHIPPING
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country

Are there any special notes and/or comments?