October 22, 2015 Auction VENDOR form

                  

 

Long Island Alarm Association

General Meeting 
“Auction/Election”
Thursday, October 22nd, 2015
Vendor Exhibits/Dinner 6:30-10:00 pm
Set up 5:30pm

UPSKY Long Island Hotel 

Formerly Sheraton LI
110 Motor Parkway Hauppauge, NY 11788

 Please let me know if you can donate any item(s) to be raffled off. 
They can be mailed call the above # for arrangements to be picked up.

 

Cost:  $250.00   Non-member price

   $200.00   Member price

 

        Vendor/Manufacturer Name:_______________________________

 

        ATTENDEE Name:              _______________________________

 

       Contact telephone #:            _______________________________

 

       Payment Type:   ____check                       ____Credit card

      (Please check one)

      ____ Mastercard                  ____Visa          ____American Express

 

 

      Card #:  __________________________  Zip code____________ 

                                                                    (affiliated with card)

       Exp ___ ___ / ___ ___                            Code: ___ ___ ___ ___